Risk for Tattoo-Related Complications in Patients With Psoriasis

Patients with psoriasis should consult a dermatologist before tattooing to determine the optimal time in disease status for the procedure and to be educated on the associated risks for subsequent infection, according to study findings published in Clinical, Cosmetic, and Investigational Dermatology.

Using an online questionnaire, researchers surveyed patients with psoriasis with at least 1 tattoo to assess their knowledge of the potential risks associated with the procedure. The questionnaire comprised 3 parts, capturing information on patients’ history of psoriasis, demographic characteristics, and the effects of tattooing on self-esteem.

Among 150 patients included in the study, the mean age was 32 (range, 16-62) years, 10.6% were men, 95.3% had early onset psoriasis, 76% received a tattoo following their diagnosis, and 67.3% were receiving treatment at the time of tattooing. The most common treatments for psoriasis included topical treatment (69%), followed by systemic therapy (15.3%) and biologic agents (6%). Although some patients (18%) were advised to receive a medical consultation, only 8% consulted a dermatologist before obtaining a tattoo.

In all, 8.7% of patients reported tattoo-related cutaneous complications. Of these patients, 5 were receiving topical treatment for psoriasis, 1 systemic therapy, and 1 had consulted a dermatologist before the procedure. The most frequently reported complications included Koebner phenomenon in 5.3% of patients, generalized psoriasis flares in 1.3%, pruritic rash in 1.3%, and delayed healing due to prolonged inflammation at the tattoo site in 0.7%.

In regard to patients’ rationales for tattooing, the majority (76%) reported a desire to improve their appearance. Other rationales included a desire for self-expression (60%), commemoration of an important event (39.3%), a desire to draw attention away from psoriasis (4.7%), and camouflaging psoriatic lesions (2.7%). Approximately half of the patients (50.7%) reported tattoos increased their self-esteem.

This study was limited by its survey-based design, potentially inconsistent demographic data, and the lack of men.

According to the researchers, “…more studies should be performed to [assess] the influence of systemic treatment [for psoriasis] on the safety of tattooing.” They concluded, “tattooists should be educated about the possible health complications connected with tattooing and on the precautions that should be followed.”

Reference

Rogowska P, Walczak P, Wrzosek-Dobrzyniecka K, Nowicki RJ, Szczerkowska-Dobosz A. Tattooing in psoriasis: A questionnaire-based analysis of 150 patients. Clin Cosmet Investig Dermatol. 2022;15:587-593. doi:10.2147/ccid.s348165