Willardson Hal Bret, Kobayashi Todd T, Arnold Jason G, Hivnor Chad M, Bowen Casey D
1 Transitional Year Intern, Transitional Year Program, San Antonio Uniformed Services Health Education Consortium (SAUSHEC) , San Antonio, Texas.
2 Dermatology Residency, San Antonio Uniformed Services Health Education Consortium (SAUSHEC) , San Antonio, Texas.
Photomed Laser Surg. 2017 Mar;35(3):176-180. doi: 10.1089/pho.2016.4162. Epub 2017 Jan 2.
Local and generalized allergic reactions following laser tattoo removal have been documented, but are rare. To our knowledge, this is the fourth documented case of widespread urticarial eruptions following laser tattoo removal treatment. Unlike previously documented cases, this patient's reaction was found to be associated with titanium dioxide within the tattoo and her symptoms were recalcitrant to medical therapy.
A 46-year-old female experienced diffuse urticarial plaques, erythema, and pruritis following multiple laser tattoo removal treatments with an Nd:YAG laser. The systemic allergic reaction was recalcitrant to increasing doses of antihistamines and corticosteroids. The tattoo was finally surgically excised. The excised tissue was analyzed by scanning electron microscopy and energy-dispersive X-ray analysis and contained high levels of titanium dioxide. Two weeks following the excision, and without the use of medical therapy, the patient had complete resolution of her generalized urticaria.
Ours is the first documented case of a diffuse urticarial reaction following laser tattoo removal treatments that shows a strong association to titanium dioxide within the tattoo pigment. Herein, we describe a novel surgical approach to treat recalcitrant generalized allergic reaction to tattoo pigment.
激光纹身去除术后的局部和全身性过敏反应已有文献记载，但较为罕见。据我们所知，这是第四例有文献记载的激光纹身去除治疗后出现广泛荨麻疹样皮疹的病例。与先前文献记载的病例不同，该患者的反应被发现与纹身中的二氧化钛有关，且她的症状对药物治疗反应不佳。
一名46岁女性在接受多次Nd:YAG激光纹身去除治疗后，出现弥漫性荨麻疹斑块、红斑和瘙痒。全身过敏反应对增加剂量的抗组胺药和皮质类固醇治疗反应不佳。纹身最终通过手术切除。切除的组织经扫描电子显微镜和能量色散X射线分析，发现含有高水平的二氧化钛。切除术后两周，未使用药物治疗，患者的全身性荨麻疹完全消退。
我们的病例是第一例有文献记载的激光纹身去除治疗后出现弥漫性荨麻疹反应，且与纹身色素中的二氧化钛有强烈关联的病例。在此，我们描述了一种治疗对纹身色素顽固性全身性过敏反应的新手术方法。
