Basal cell carcinoma arising in a tattoo

Abstract

Conflict of interest: none declared. A 28‐year‐old woman presented with an asymptomatic nodule arising from a tattoo on her central back. Her medical history was unremarkable; in particular, there were no specific risks for the development of nonmelanoma skin cancer. Examination revealed a 6‐mm pearly nodule with telangiectases arising from an Indian‐ink tattoo that had been performed 6 years earlier (Fig. 1). The nodule showed characteristic arborizing telangiectasia under the dermatoscope, and was diagnosed clinically as a basal cell carcinoma (BCC). The lesion was excised with a 4‐mm margin and histology confirmed a BCC of no special type extending into the deep reticular dermis (Fig. 2). Extraneous dark pigment was seen within the perivascular macrophages of the surrounding tissue. The tattoo pigment was coarse and clumped compared with the fine granular melanin in the basal layer above. There have been six previous reports of BCCs arising in tattoos, but it is not clear whether the tattoo itself increases the risk of developing a tumour or whether, as BCCs are very common, it is a chance finding that they occurred, incidentally, within a tattoo.

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