Tattoos May Hide Suspicious Nevi
Tattoo culture is peaking across the United States. Some studies suggest that over 1 in 5 adults in the US have a tattoo, and more people are getting tattoos every year. With this increase, dermatologists are seeing higher demand for laser removal for spur-of-the-moment mistakes and youth regrets. Unfortunately, lasers do not exactly work like erasers and patients will be required to come in for many treatments. The process is lenthy and complicated particularly when pigmented lesions are found in tattooed areas.
A 2013 case study describes a man with a pigmented lesion in a decorative tattoo found during assessment before laser tattoo removal. Dermatologists were unable to see changes within the nevus due to the black ink surrounding it. The patient refused excision despite strong requests by dermatologists. After 47 laser sessions, the doctors refused to continue treatment unless the nevus was removed. Dermoscopy results presented signs of early melanoma. Biopsy results showed the lesion to be a superficial spreading malignant melanoma.
Many tattoo artists are unaware of the risks as they tattoo over their clients’ nevi. Tattoos can hide suspicious nevi, making them difficult to assess clinically. Pigment from the tattoo can also mimic metastatic disease, making it difficult for pathologists to diagnose. A tattoo with a pigmented lesion in it should not be treated by a laser because forensic consideration and possible changes in the nevi from the laser.
No studies prove that tattooing nor laser treatment change benign nevi into melanoma. More research and case study reports are needed. Still authors stress the importance of checking thoroughly for pigmented lesions in tattooed areas before laser removal treatment.
Image: Binder Donedat