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OBJECTIVE: The objective of this study was to determine the safety of tattoos in patients with systemic lupus erythematosus (SLE). METHODS: 147; ≤55 years; 92% women) were asked if they had tattoos. The characteristics of the tattoos and the immediate complications were investigated and compared with those of a matched control group. We examined retrospectively after the tattoo was completed whether there had been flare-ups or increased organ damage (Systemic Lupus International Collaborating Clinics/American Collage of Rheumatology Damage Index (SDI)). Finally, we compared the SLE-related characteristics of patients with and without tattoos. RESULTS: Twenty-eight patients (19%, 26 women, median (interquartile range) age 33 (25-42) years, 65 tattoos in total) had ≥1 tattoo. At the time the tattoo was done the median (interquartile range) SLEDAI and SDI were 2 (0-2) and 0 (0-1), respectively. The characteristics of the tattoos were similar to those of controls. No patients experienced acute complications. After a median follow-up of 17 (12-20) months (3 (2-4) visits/year) four patients had five mild-to-moderate flare-ups. The median time between the tattoo and the flare-up was 9 (6-14) months. No increase in SDI was observed. The SLE-related characteristics of patients with and without tattoos were similar. CONCLUSION: Tattoos seem to be safe in SLE patients with inactive or low active disease.
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