As tattoos are getting increasingly popular with almost 20% of adults having at least one tattoo, one of the issues, that has arisen, is the risk associated with moles.
Tattooing on a melanocytic lesion can trigger traumatic clinical and histological modifications that will lead to excision and analysis to rule a malignancy. Large tattoos may cloud the proper surveillance of patients with atypical mole syndrome or numerous moles. Dermoscopy may be challenging due to the superposition of melanocytes and tattoo pigments. Hopefully, the development of melanoma remains rare and is still considered to date as a fortuitous event.
In almost 80% of the cases, melanoma developed de novo within the tattoos. Fortunately, not all pigmented lesions within tattoo are melanomas. Cases of seborrheic keratoses, warts and spitz nevus have been described. The main common-sense rule is to avoid getting a tattoo on any pigmented lesions. Besides, as a rule, tattoos should not be done over a preexisting lesion without diagnostic. Of course, surgical scar of melanoma should never be tattooed to allow clinical surveillance. In case of doubt, tattoo session should be postponed, or the customer should choose another area to get the tattoo and referral to the GP or the dermatologist is then warranted.
Tattooist’s training is also important. Tattooists should be aware that skin lesions should not been tattooed without any medical evaluation. They should leave spaces if they are tattooing in the vicinity of tattoos and leave about 0.5 to 1 cm around each naevus. The question of the role of tattooists in melanoma screening remains open but has also ethical limitations that need to be addressed.
By Dr. Nicolas Kluger