Cutaneous lymphoid hyperplasia (pseudolymphoma) in tattoos: a case series of seven patients

Background Cutaneous lymphoid hyperplasia (CLH or pseudolymphoma) is considered a rare complication occurring in tattoos. We analysed the demographics, clinical features, histological aspects, allergy tests, outcome and therapeutic data of CLH in tattoos performed by a professional in a series of patients. Methods We conducted a retrospective chart review of seven patients managed in private practice of dermatology all over France from 2001 to 2007. Results Reactions occurred within 2 years after tattooing, were non‐specific (pruritus, swelling, infiltration) and mainly restricted to red. Photosensitivity was noted in two cases. Histology was characteristic of pseudolymphoma with a T‐cell predominance in all cases. Surgery (2 cases) and laser removal (2 cases, CO2 and QS‐532 nm) were efficient, while local corticosteroids were not. One patient had spontaneous clinical remission after 2 years of evolution. Conclusions This is the largest series of CLH occurring in tattoos. This delayed hypersensitivity reaction may be underestimated and triggered by a specific immunogenic compound of the ink. Its management remains difficult.