학술논문
The Koebner phenomenon on tattoos and piercings in a patient with cutaneous lupus: a case report and review of the literature
Document Type
Academic Journal
Source
Acta Dermatovenerologica Alpina, Pannonica et Adriatica. January 2021, Vol. 30 Issue 1, p43, 4 p.
Subject
Language
English
ISSN
1318-4458
Abstract
Introduction The Koebner phenomenon (KP) has been described in patients with lupus (1). We report here the case of a young woman that developed specific cutaneous lupus erythematosus (CLE) on [...]
The Koebner phenomenon is associated with cutaneous lupus erythematosus (CLE). A 20-year-old woman with a 10-year history of systemic lupus, treated with hydroxychloroquine and methotrexate, presented with features of chronic discoid lupus erythematosus (DLE) on the scalp, at the site of ear piercings, and on the temporal bone at the site of trauma from her jewelry. She also had subacute CLE (SCLE) lesions on old black tattoos. Histology and direct immunofluorescence confirmed CLE. We reviewed 13 cases of Koebner phenomenon on tattoos in patients with CLE (seven men, median age: 31.5 years) and none after piercings. Lesions developed within 1 week to 16 years after tattooing. Lesions may be isolated, precede, or be associated with other CLE lesions. They can appear secondarily on the tattoo. There is no specific color affinity, but cases have shifted from red to black, possibly when mercury was withdrawn from red inks. CLE on tattoos is a rare phenomenon that more often presents with DLE features than SCLE. Patients should be warned of the potential risk of developing lesions on tattoos. Immunosuppressive treatment needs to be taken into account if a patient wishes to get a tattoo. However, tattooing is not associated with severe complications. Keywords: clinical dermatology, connective tissue, cutaneous lupus, dermatology, epidermal barrier, Koebner phenomenon, lupus, piercing, scars, tattooing Received: 15 August 2020 | Returned for modification: 13 October 2020 | Accepted: 11 December 2020
The Koebner phenomenon is associated with cutaneous lupus erythematosus (CLE). A 20-year-old woman with a 10-year history of systemic lupus, treated with hydroxychloroquine and methotrexate, presented with features of chronic discoid lupus erythematosus (DLE) on the scalp, at the site of ear piercings, and on the temporal bone at the site of trauma from her jewelry. She also had subacute CLE (SCLE) lesions on old black tattoos. Histology and direct immunofluorescence confirmed CLE. We reviewed 13 cases of Koebner phenomenon on tattoos in patients with CLE (seven men, median age: 31.5 years) and none after piercings. Lesions developed within 1 week to 16 years after tattooing. Lesions may be isolated, precede, or be associated with other CLE lesions. They can appear secondarily on the tattoo. There is no specific color affinity, but cases have shifted from red to black, possibly when mercury was withdrawn from red inks. CLE on tattoos is a rare phenomenon that more often presents with DLE features than SCLE. Patients should be warned of the potential risk of developing lesions on tattoos. Immunosuppressive treatment needs to be taken into account if a patient wishes to get a tattoo. However, tattooing is not associated with severe complications. Keywords: clinical dermatology, connective tissue, cutaneous lupus, dermatology, epidermal barrier, Koebner phenomenon, lupus, piercing, scars, tattooing Received: 15 August 2020 | Returned for modification: 13 October 2020 | Accepted: 11 December 2020