Fibroepithelioma of Pinkus
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News about Skin Diseases From a Microscopic Eye!
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Feature Article
How Can a Dermatopathologist Help Me?
Medical Terms You Should Know
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The Truth About Tattoos
Tattoo Reaction
Learn the truth about tattoos and body piercings from the American Academy of Dermatology.

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April 2009

The Dermatopathology Institute analyzes the current stories making headlines in dermatology with a viewpoint from the microscope, helping you to truly understand all of the nuances of the disease.

We enjoyed meeting so many of you at our recent hospital and community presentations. If you would like a presentation at your facility, please contact us.

Some of you may be interested in reviewing our other two newsletters. One newsletter is a weekly update that is distributed to our dermatology residents and faculty. The second newsletter is distributed monthly to practicing dermatologists and pathologists. All of these newsletters may be accessed at this link.

Archived Newsletters

Thank you!
The Dermatopathology Institute
How Can a Dermatopathologist Help Me?
Tounge Tattoo Can Tattoos be Harmful?
I asked myself this question when I saw this actual tounge tattoo. A tounge tattoo is still used by many cultures, although in Western societies, it may seem unusual. But aside from the obvious initial pain, bleeding, and possible infection risk, are there are any harmful side effects or bad outcomes? Unfortunately yes.

Some of the tattoo pigment or ink may cause an allergic reaction, sometimes months to years after the initial tattoo. While this reaction may clear on its own, occasionally, it may represent an infection, particularly with rare variants of Mycobacterium, within the same family of bacteria that causes tuberculosis. Other reactions include a granuloma. This is a specialized response of the body to surround and wall off a foreign body. Finally, there are rare examples of a cancer arising within a tattoo, leading to speculation that the chronic injury may predispose the area to develop a cancer. Just like a mole, any change in the appearance of a tattoo should be examined by a dermatologist or other qualified health professional.

A skin biopsy is the only unequivocal way to understand what is happening in a changing tattoo. If a granuloma is present, the dermatopathologist should always alert the treating physician that the patient may have an underlying condition known as sarcoidosis. This rare condition may also result in granulomas in other organs including the lungs and lymph nodes.
Medical Terms You Should Know
Sarcoidosis Granuloma

A granuloma is a collection of specialized cells known as epithelioid histiocytes. Histiocytes normally function to engulf foreign material. Under certain circumstances, the histiocytes may form a cohesive nodule known as a granuloma (see photo above). A granuloma may be seen in many disease conditions including infections, foreign bodies, inflammatory dermatoses, systemic diseases, and even malignancies. Thus, a dermatopathologist must be able to integrate the clinical information with the changes that are being viewed on the microscope slide.

Additional Links

The Doctor's Doctor-Basic Principles of Disease

The Doctor's Doctor-Sarcoidosis
Thank you for taking the time to visit with us.

Tattoos may elicit strong emotional response from both the bearers and observers. If you have a tattoo, it is important to remember that the ink is a foreign material and the body may react to it.

Please call or email us to schedule a consultation for you or your loved ones.
Thank you!

Paul K. Shitabata, M.D.
President and Medical Director
Dermatopathology Institute