A cystic fibrosis patient was left in chronic pain after getting a tattoo because of her compromised immune system.
The woman, from Scotland, had a large coloured ink tattoo on her left thigh in 2015 – but developed chronic pain within months.
Doctors today called for people with weak immune systems to steer clear of getting a tattoo because of the landmark case.
The unidentified 31-year-old’s reaction to her inking is believed to be the first ever recorded case of inflammatory myopathy.
Medics at the NHS Greater Glasgow and Clyde published the unusual tale in the British Medical Journal Case Reports.
The woman, from Scotland, had a large coloured ink tattoo on her left thigh in 2015 – but developed chronic pain within months
They wrote: ‘To our knowledge, there have been no previously reported cases of tattoo-associated reactions causing an inflammatory myopathy.
‘This is a unique adverse reaction following a tattoo, and given the increasing popularity of inking, it should remain an important point for medical professionals to consider during a consultation.
‘Doctors should counsel immunosuppressed patients appropriately at an early stage of the dangers relating to tattoos.
‘Patients have a responsibility to consider carefully the decision whether to undergo the tattoo, and if so, to time this appropriately such as a time when on minimal immunosuppression.’
The unnamed woman with cystic fibrosis had a large coloured ink tattoo on her left thigh in 2015, doctors led by William Wilson wrote.
But within months she began to get chronic pain in her left hip, knee and thigh but doctors were initially puzzled what was causing it.
Complications from a ‘bad tattoo’ are quite common, ranging from minor skin irritation to severe infection causing death.
The woman had been taking drugs to dampen down her immune system for several years after receiving a double lung transplant in 2009.
An MRI scan shows a section of her left distal thigh/knee showing extensive oedema (watery fluid) within her vastus medialis – a muscle in the thigh that extends the knee
An MRI scans shows a section of her left distal thigh/knee showing extensive oedema within vastus medialis and effusion within the knee joint
Several years before that she had a tattoo on her right leg without any side effects, so decided to have one on her left leg too.
Immediately she experienced mild skin irritation, which is not unusual. But nine days later, she developed severe pain in her left knee and thigh.
Although her symptoms eased after she was given strong painkillers, they were still troubling her 10 months later, so she was referred to a rheumatology clinic.
Tests came back negative – until a biopsy of her thigh muscle revealed that she had inflammatory myopathy, or chronic muscle inflammation.
It often results in muscle weakness and pain, and often the cause is unknown.
Doctors concluded the woman’s reaction was likely to be linked to getting the tattoo and her compromised immune system, although there was no definite proof.
She had a period of physiotherapy for basic quadriceps strengthening exercises and one year after the onset of her symptoms, her condition started to improve.
Three years later, she is pain free and back to her normal activities, Mr Wilson and his colleagues wrote in the journal.
Experts said doctors should advise patients with a weakened immune system of the risks of getting an inking.
An MRI scan of her left distal thigh/knee shows a build-up of oedema in her vastus medialis
Mr Wilson said: ‘The prevalence of tattoos has been increasing, as has the incidence of associated complications.
‘These have been well documented and can be local or systemic infections as well as variety of skin reactions.
‘To our knowledge, there have been no previously reported cases of tattoo-associated reactions causing an inflammatory myopathy.
‘This could be a rare occurrence or represent an under-diagnosis for patients presenting with similar symptoms having had tattoos.
‘Inflammatory myopathies are a group of diseases that involve chronic muscle inflammation, which can lead to pain and muscle weakness.’
He added that it is ‘well recognised ‘that adverse tattoo reactions can arise from the type of ink or colouring agent used.
Most commonly issues are seen with red ink. But there was a variety of coloured ink used in the woman’s tattoo, which may explain her reaction.
Mr Wilson said: ‘The tattoo industry has no regulated or professional body to enhance standards across the UK.
‘And there have been cases of black ink being diluted to grey ink with non-sterile tap water, causing infection.
‘In this case, the tattoo application by an unregulated parlour, combined with the patient’s immune suppression could have resulted in the adverse reaction.