During his training, Sebastiaan van der Bent, now a dermatologist at the Alrijne hospital, saw a patient with an allergic reaction to a tattoo and discovered that hardly any research had been done into this. That was the beginning of the tattoo clinic and its PhD trajectory. He will receive his doctorate at the VU on Friday, April 9.
Red pigments are often the triggers of chronic skin reactions to tattoos. To investigate how this is possible, Van Der Bent performed histopathological research on 74 skin biopsies. There he found a remarkable inflammatory pattern in the majority that he said points towards an immune-mediated allergic reaction that appears to be specific to red tattoo pigments. A four-year prospective study in 101 people also showed that this is a delayed allergic reaction. On average, it only occurred 12 months after tattooing. Sunlight also appears to play a role in the development of allergens. The forearms and legs and face were by far the most affected and exposure to sunlight exacerbated the symptoms in some.
The thesis is illustrated with images of tattoos with blisters, scabs and swelling that show that the skin reactions can be severe. The first-line treatment consists of topical corticosteroid administration, but this usually only produces a limited or temporary effect. The red tattoo pigments penetrate deep into the dermis. A small retrospective study shows that an ablative CO2laser treatment is an option after this. This reduced the complaints in fifteen of the sixteen patients, although eleven people did report scars afterwards.
In his thesis, Van Der Bent also describes a granulomatous response to permanent eyebrow make-up in five patients. In one of them, this reaction turned out to be the first manifestation of sarcoidosis – the Köbner phenomenon. An online questionnaire of 212 sarcoidosis patients found that one in five had a tattoo; and just as many indicated that they experienced skin complaints, especially in the form of papules and nodules. Here, black tattoos were usually the culprits, but they are also the most common. It is estimated that 10 to 20 percent of people have a tattoo. In the first chapter of his dissertation he provides a comprehensive overview of various tattoo complications, including infections.