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10.18 Traumatic Tattoos and Abrasions


Presentation

The patient will usually have fallen onto a coarse surface such as a blacktop or macadam road. Most frequently, the skin of the face, forehead~ chin, hands and knees are abraded. When pigmented foreign particles are impregnated within the dermis adventita, tattooing will occur. An explosive form of tattooing can also be seen with the use of firecrackers, firearms, and homemade bombs.

What to do:

What not to do:

Discussion:

The technique of tattooing involves painting pigment on the skin, and then injecting it through the epidermis into the dermis with a needle. As the epidermis heals, the pigment particles are ingested by macrophages and permanently bound into the dermis. Immediate care of traumatic tattoos is important because once the particles are embedded and healing is complete, it becomes difficult to remove them without scarring. It is advisable for a patient to protect a dermabraded area from sunlight for approximately 1 year to minimize excessive melanin pigmentation of the site.

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Craig Feied, MD
Mark Smith, MD
Jon Handler, MD
Michael Gillam, MD