![]() ![]() At the request of the attendant physician, the Forensic and Toxicological Laboratory of the Aristotle University of Thessaloniki proceeded with an investigation for detection of mercury in biological samples of whole blood, urine, and hair. When the lesions were incised, metallic foreign bodies were found which were examined and verified macroscopically by the laboratory of the Polytechnic of Crete, to be metallic Mercury. He was submitted to plain X-ray imaging of his arm, which showed multiple confluent subcutaneous radiopaque deposits in the soft tissues of the arm ( Figure 1). The inflammation subsided without completely disappearing. ![]() Subsequently, he was admitted to a general hospital in Athens where he was treated with intravenous (IV) antibiotics. He was initially administered a course of oral antibiotics (amoxicillin/clavulanic acid 500/125 mg, three times daily for ten days), without any improvement of the local symptoms. He reported that 20 days later he developed persistent inflammation and erythema in the arm, which he initially attributed to accidental scalding with hot water. ![]() We report the case of a 14-year-old male adolescent who underwent amateur tattooing to his left arm which was reported to have completely disappeared after three weeks. The poisoning was confirmed by detection of mercury in blood, urine, and hair samples. The purpose of this paper is to describe the unusual case of mercury poisoning manifested with local skin reactions in a young person following amateur tattooing. It must be noted that mercury sulfide causes irritation of the epidermis that cannot be clinically differentiated from eczema 2, 3. The use of mercury in tattooing can be considered as a single dose of exposure to a toxic substance 1. Also, mercury sulfide or cinnabar (HgS) constitutes one of the main ingredients in the manufacturing of red dyes used in tattoo application. Mercury has been used, for example in the industry for the production of thermometers, batteries, switches, manometers, X-ray bulbs, as well as, filling materials in dentistry. ![]() In general, currently there are reported to be approximately 3,000 applications of mercury and its compounds, therefore, the probability of mercury poisoning cannot be considered negligible. Mercury can be used as metal form (Hg 0), in the form of inorganic compounds of monovalent (Hg +), or bivalent (Hg +2), or in the form of organic compounds, the latter being more interesting in toxicology. Mercury is a metallic element with natural deposits in the environment that can be found in nature in several forms, which are well-known since antiquity. In the literature, many conditions have been documented in association with tattoos and the process of tattoo application, especially when red dyes are used, but no similar cases of elemental mercury poisoning from the tattoo dye exist. The poisoning was confirmed by detection of mercury in blood, urine, and hair samples.Ĭonclusion: This is a rare case of tattoo-associated skin reaction and mercury poisoning by the elemental form of mercury contained in the tattoo dye. The unique feature of this case is the use of the elemental form of mercury in the tattoo dye and the resulting mercury poisoning. The tattoo induced inflammatory foreign body reactions and required multiple surgical excisions to be removed. Early identification and proper treatment of these skin lesions is challenging and necessitates close coοperation of different medical specialties.Ĭase description: We report an unusual case of mercury poisoning in a young person manifested with local skin reactions following amateur tattooing. Cutaneous lesions associated with tattoos can be divided into three major groups: allergic/granulomatous/lichenoid, infectious, and coincidental lesions. Consequently, tattoo reactions are seen more commonly than in the past. Background: Tattoos have become very popular in modern societies due to the gradual change in aesthetics and psychosocial acceptability. ![]()
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