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Are Contact Allergies due to Tattooing a Problem ?
Observations from the IVDK
Axel Schnuch
IVDK
Göttingen
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I V D K:
>50 dermatological
centres in
central Europa
- Register Data on allergic Contact Dermatitis
- > 12.000 Patients / Year
- > 250.000 Patients collected
- Data centre in Göttingen
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p-Phenylenediamine
….data on allergic contact dermatitis:
Results of Allergy Tests („patch tests“)
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Data on allergic contact dermatitis
-Patch test data (sensitization to ?)
-Exposure data (occupation, „contactant“ – sentization caused by ?
-Clinical data (e.g. site of eczema) K1 Textiles
K2 cosmetics/creams
K5 drugs
K11 Rubber
K51 TATTOOS
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Data registered in the IVDK from 2004 to 2012.
n= 116.484
Is there a role for tattooing in allergic contact dermatitis ?
Selection and analysis of the „K51“ subpopulation:
n= 112 (= 0.1%)
NO
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Selection and analysis of the „K51“ subpopulation:
Patients were patch tested
a) with commercial patch test preparations
b) (some) with their „own material“ (e.g. tattoo material)
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Results of patch testing:
a) commercial patch test preparations
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Results of patch testing:
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Possible explanations for this allergen pattern:
1. Primary sensitization to PPD (through temporary / Henna tattoos ?)
and cross reactions to other dyes
2. Primary sensitization to amino- and azo- dyes and cross reactions to PPD
and derivatives
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NH2
NH2
p-Phenylendiamin
NH2
NH2
CH3
p-Toluylendiamin
Cross reactions:
~ 3 / 4 of PPD allergics react to PTD*
*IVDK 2007 - 2009
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Results of patch testing:
Some patients (n=75) were patch tested with their „own material“
n= 24 with tattoo material
5/24 reacted to tattoo material
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Results of patch testing:
Some patients (n=75) were patch tested with their „own material“
n= 24 with tattoo material)
5/24 reacted to tattoo material
Permanent Make up lila 100 % ++Permanent Make up bräunlich 100 % +
Allergen ?
Substanz für Tattoo 100 % +
Allergen ?
1.
2.
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Results of patch testing:
5/24 reacted to tattoo material
Tattoofarbe rosa 100 % (+)
Allergens
Cadmiumchlorid 0.5 % Petr ++
Cadmiumsulfat 2 % Aqu +Eisensulfat 5 % Petr ++
3.
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Results of patch testing:
5/24 reacted to tattoo material
Tattoofarbe 1:10 100 % +
Allergens
Ammoniumpersulfat 2.5 % Petr +
Narcissus absolut 2 % Petr +
4.
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Results of patch testing:
5/24 reacted to tattoo material
Deep Purple 20 z 100 % +
Allergens
p-Phenylendiamin (CI 76060)
1 % Petr +
5.
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Intermediate Summary:
1. Contact allergy is rarely caused by tattooing
2. The allergen frequency and spectrum (aromatic amines) is plausibel
3. Anorganic pigments are rarely the cause of contact allergy
(except Ni containing)
HOWEVER:
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A potent contact
allergen !
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Identification of new problems by surveillance
Chlormethylisothiazolinon Methylisothiazolinon
Preservative
in:
- paints
-glues
-metal working fluids,
- liquid soaps….
-Cosmetics
Tattoo inks
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MCI/MI
MCI/MI
Allergic reactions to Methylisothiazolinone (IVDK 2009 and 2012)
females males
< 2%
> 7% Mostly caused by
cosmetics.
Role of tattoos ??
2009 2012
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Are Contact Allergies due to Tattooing a Problem ?
(aromatic amino /azo compounds)
in tattoos
Textile allergy
Hair dye allergy
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Are Contact Allergies due to Tattooing a Problem ?
Preservative: methylisothiazolinone
in tattoos
Wall paints
cosmetics
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The Problem:
„Promiscuity of
the allergen“
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R. Chitry et al. Derm (9): 256 (2003)
Thank you for your
attention