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J Am Acad Dermatol. 2010 Mar;62(3):501-6. doi: 10.1016/j.jaad.2009.03.034. Epub 2009 Sep 6.

An outbreak of Mycobacterium chelonae infections in tattoos.

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  • 1Division of Clinical Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.


Nontuberculous mycobacteria infections may occur after cutaneous procedures. Review of the medical records of patients who developed a rash within a tattoo revealed 6 patients with skin infections caused by Mycobacterium chelonae after receiving tattoos by one artist at a single tattoo establishment. The interval between tattoo placement and the skin findings was 1 to 2 weeks. All patients received alternate diagnoses before mycobacterial infection was identified. Skin findings included pink, red, or purple papules; papules with scale; pustules; granulomatous papules; and lichenoid papules and plaques. Histopathologic examination revealed granuloma, lymphohistiocytic infiltrate, or mixed inflammation; acid-fast bacilli stains produced negative results. Diagnosis was made by culture in 3 patients, histopathology in two patients, and clinical/epidemiologic association in one patient. The M chelonae isolates were clarithromycin susceptible, and the infections responded to macrolide antibiotics. Physicians should consider mycobacterial infections in patients with skin findings within a new tattoo.

Copyright 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

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