Schwob E, Kluger N
Département de dermatologie, CHRU de Montpellier, hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34090 Montpellier, France; Cabinet privé de dermatologie, villa Medica, 400, avenue des Abrivados, 34400 Lunel, France.
Consultation « tatouages », service de dermatologie, hôpital Bichat, Assistance publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75877 Paris cedex 18, France; Department of dermatology, allergology and venereology, Helsinki university hospital, Meilahdentie 2, PO Box 160, 00029 Helsinki, Finlande.
Ann Dermatol Venereol. 2020 Oct;147(10):637-642. doi: 10.1016/j.annder.2020.04.019. Epub 2020 Jul 9.
Tattoos are occasionally associated with cutaneous infections. Diagnosis can be challenging as the clinical presentation of such infections may differ from those on plain skin. Herein we report an atypical form of tinea corporis restricted to two recent tattoos during healing, caused by environmental contamination. We reviewed the literature for all cases of fungal infection after tattooing.
A 27-year-old female patient was seen for ring-shaped, erosive, oozing, pruritic and rapidly extensive skin lesions as well as infiltrated papular lesions occurring on tattoos done 6 and 12 days earlier. Fungal analysis revealed Microsporum canis. History-taking indicated that the patient's cat had ringworm and that the patient's sister also had skin lesions consistent with tinea corporis.
Tinea on tattoos is rarely reported. We found ten additional cases in the literature, as well as five cases of less common fungal infections. These could be explained by the skin break created by the needle during tattooing resulting in an impaired skin barrier, or by accidental self-inoculation (e.g. foot-tattoos). The hypothesis of local immune deficiency induced by tattoo inks strikes us as rather improbable. Unlike usual cases of infections (pyogenic bacteria, mycobacteria, viral hepatitis), fungal infections are not related to a lack of hygiene on the part of the tattooist, but rather to contamination during the healing phase. Their clinical presentation may be atypical, resulting in diagnostic difficulties.
纹身偶尔会与皮肤感染相关。由于此类感染的临床表现可能与普通皮肤感染不同，诊断可能具有挑战性。在此，我们报告一例在愈合过程中局限于两处近期纹身的非典型体癣病例，由环境污染引起。我们查阅了文献中所有纹身术后真菌感染的病例。
一名27岁女性患者因6天和12天前纹身处出现环形、糜烂性、渗出性、瘙痒性且迅速蔓延的皮肤损害以及浸润性丘疹性损害前来就诊。真菌分析显示为犬小孢子菌。病史询问表明患者的猫患有癣病，且患者的妹妹也有符合体癣的皮肤损害。
纹身部位的体癣鲜有报道。我们在文献中又发现了10例病例，以及5例不太常见的真菌感染病例。这可能是由于纹身时针头造成皮肤破损导致皮肤屏障受损，或者是意外的自身接种（如足部纹身）所致。纹身墨水诱导局部免疫缺陷这一假说在我们看来相当不太可能。与常见的感染病例（化脓性细菌、分枝杆菌、病毒性肝炎）不同，真菌感染与纹身师卫生状况欠佳无关，而是与愈合阶段的污染有关。它们的临床表现可能不典型，从而导致诊断困难。
