{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T13:10:43Z","timestamp":1769087443603,"version":"3.49.0"},"reference-count":18,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,5,23]]},"abstract":"<jats:p>Tattooing for decorative body art is becoming more popular and, as a result, so are tattoo-related complications. Patients are unlikely to discuss tattoos with medical professionals, even though these might be relevant. Long-term immunosuppressed patients are often young adults who may wish to consider tattooing. It is well recognised that immunosuppressed patients are at increased risk of infection including cutaneous mycobacterial infections. They therefore represent a group that is at a potentially higher risk of tattoo-related complications and warrant special consideration.<\/jats:p>\n               <jats:p>We present the first documented case of inflammatory myopathy as a complication following tattooing in an immunosuppressed individual. This unusual case presented as distal thigh and medial knee pain and it was only after some time that a link to the tattoo was made. This serves as a reminder to consider tattoo-related complications in the differential diagnosis of unusual atraumatic musculoskeletal pain, especially in immunosuppressed individuals.<\/jats:p>","DOI":"10.1136\/bcr-2018-224968","type":"journal-article","created":{"date-parts":[[2018,6,18]],"date-time":"2018-06-18T18:45:10Z","timestamp":1529347510000},"page":"bcr-2018-224968","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Unusual complication of a tattoo in an immunosuppressed patient"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9025-081X","authenticated-orcid":false,"given":"William Thomas","family":"Wilson","sequence":"first","affiliation":[{"name":"Trauma and Orthopaedics, NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mannix","family":"O\u2019Boyle","sequence":"additional","affiliation":[{"name":"Trauma and Orthopaedics, NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William J","family":"Leach","sequence":"additional","affiliation":[{"name":"Trauma and Orthopaedics, NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,6,18]]},"reference":[{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.1","doi-asserted-by":"crossref","first-page":"30","DOI":"10.4103\/0974-2077.155072","article-title":"Complications of Tattoos and Tattoo Removal: Stop and Think Before you ink","volume":"8","author":"Khunger","year":"2015","journal-title":"J Cutan Aesthet Surg"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.2","doi-asserted-by":"crossref","first-page":"231","DOI":"10.4103\/0378-6323.107644","article-title":"Tattoo reactions--an epidemic on the surge: a report of 3 cases","volume":"79","author":"Sanghavi","year":"2013","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.3","first-page":"430","article-title":"[Skin reactions to tattoo ink]","volume":"66","author":"Pi\u00e9rard-Franchimont","year":"2011","journal-title":"Rev Med Liege"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.4","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1159\/000346943","article-title":"Adverse reactions after tattooing: review of the literature and comparison to results of a survey","volume":"226","author":"Wenzel","year":"2013","journal-title":"Dermatology"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1684\/ejd.2011.1558","article-title":"Lichenoid red tattoo reaction: histological and immunological perspectives","volume":"22","author":"Garcovich","year":"2012","journal-title":"Eur J Dermatol"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/354608","article-title":"Tattoo-associated skin reaction: the importance of an early diagnosis and proper treatment","volume":"2014","author":"Bassi","year":"2014","journal-title":"Biomed Res Int"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.7","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/bjd.12901","article-title":"Cutaneous Mycobacterium chelonae infection in Edinburgh and the Lothians, South-East Scotland, U.K","volume":"171","author":"Scott-Lang","year":"2014","journal-title":"Br J Dermatol"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2006.03.026"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.9","unstructured":"Kazandjieva J , Tsankov N . 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Clin Dermatol 2010."},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.10","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.lpm.2016.02.016","article-title":"Cutaneous and systemic complications associated with tattooing","volume":"45","author":"Kluger","year":"2016","journal-title":"Presse Med"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.11","doi-asserted-by":"crossref","first-page":"2055","DOI":"10.1016\/j.ajem.2012.06.014","article-title":"Acute complications of tattooing presenting in the ED","volume":"30","author":"Kluger","year":"2012","journal-title":"Am J Emerg Med"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.12","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.clindermatol.2015.07.003","article-title":"Complications of decorative tattoo","volume":"34","author":"Shinohara","year":"2016","journal-title":"Clin Dermatol"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.13","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.jemermed.2013.08.048","article-title":"Streptococcal necrotizing myositis: a case report and clinical review","volume":"46","author":"Hourmozdi","year":"2014","journal-title":"J Emerg Med"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.14","doi-asserted-by":"crossref","first-page":"e12689","DOI":"10.1111\/tid.12689","article-title":"Purpureocillium lilacinum tattoo-related skin infection in a kidney transplant recipient","volume":"19","author":"Trinh","year":"2017","journal-title":"Transplant Infectious Disease"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.15","doi-asserted-by":"crossref","first-page":"1237.e3","DOI":"10.1016\/j.ajem.2010.08.030","article-title":"Ink sick: tattoo ink hypersensitivity vasculitis","volume":"29","author":"Hessert","year":"2011","journal-title":"Am J Emerg Med"},{"key":"2025082701490758000_2018.jun04_2.bcr-2018-224968.16","doi-asserted-by":"crossref","unstructured":"Serup J , Hutton Carlsen K , Sepehri M , et al . Tattoo Complaints and Complications: Diagnosis and Clinical Spectrum: In. 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