Asymptomatic Tattoo-Associated Cutaneous Nontuberculous Mycobacterial Infection: Case Report.
Chris Alihosseini, Milana Stein, Ana Sofia Acosta Madiedo et al.
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Case in brief
An immunocompetent 28-year-old man presented with monomorphic papules bearing collarettes of scale, diffusely distributed but confined to recently tattooed skin. Biopsy showed an atypical lichenoid vacuolar interface dermatitis, a finding that did not by itself establish the cause. Tissue culture, positive after prolonged incubation, confirmed Mycobacterium abscessus complex infection. The report emphasizes early biopsy and mycobacterial culture, followed by prolonged combination antimicrobial therapy; the abstract does not specify the treatment regimen or clinical outcome.
What made this case unusual
The infection presented as asymptomatic papules with an atypical lichenoid interface pattern on histology, rather than a more readily suggestive pustular, nodular, or abscess-like eruption.
Diagnostic / clinical pearl
In a tattoo-confined eruption with atypical morphology or histology, obtain tissue for mycobacterial culture and allow for prolonged incubation; routine clinical appearance and biopsy findings may not identify the organism.