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Journal of the American Academy of Dermatology
Volume 62, n° 3
pages 501-506 (mars 2010)
Doi : 10.1016/j.jaad.2009.03.034
Case Reports

An outbreak of Mycobacterium chelonae infections in tattoos

Lisa A. Drage, MD a, , Phillip M. Ecker, MD a, Robert Orenstein, DO c, P. Kim Phillips, MD b, Randall S. Edson, MD c
a Division of Clinical Dermatology, Mayo Clinic, Rochester, Minnesota 
b Division of Dermatologic Surgery, Mayo Clinic, Rochester, Minnesota 
c Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota 

Reprint requests: Lisa A. Drage, MD, Division of Clinical Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905.

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.

The full text of this article is available in PDF format.

Key words : atypical mycobacteria, Mycobacterium chelonae , nontuberculous mycobacteria, rapidly growing mycobacteria, skin and soft tissue infection, tattoo complication, tattoo infection

Abbreviations used : AFB, NTM, RGM

 Funding sources: None.
Conflicts of interest: None declared.

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