Cutaneous lymphoid hyperplasia (pseudolymphoma) in tattoos: a case series of seven patients.

Background: Cutaneous lymphoid hyperplasia (CLH or pseudolymphoma) is considered a rare complication occurring in tattoos. We analysed the demographics, clinical features, histological aspects, allergy tests, outcome and therapeutic data of CLH in tattoos performed by a professional in a series of patients.

Methods: We conducted a retrospective chart review of seven patients managed in private practice of dermatology all over France from 2001 to 2007.

Results: Reactions occurred within 2 years after tattooing, were non-specific (pruritus, swelling, infiltration) and mainly restricted to red. Photosensitivity was noted in two cases. Histology was characteristic of pseudolymphoma with a T-cell predominance in all cases. Surgery (2 cases) and laser removal (2 cases, CO2 and QS-532 nm) were efficient, while local corticosteroids were not. One patient had spontaneous clinical remission after 2 years of evolution.

Conclusions: This is the largest series of CLH occurring in tattoos. This delayed hypersensitivity reaction may be underestimated and triggered by a specific immunogenic compound of the ink. Its management remains difficult.