Melanoma and tattoos: a case report and review of the literature

Francesco Ricci, Andrea Paradisi, Stephanie Alissa Maier, Maximilian Kovacs, Maurizio Podda, Ketty Peris, Damiano Abeni

Malignant melanoma cases arising in tattoos have been increasingly described, however, there is no clear relationship between this practice and the development of cutaneous malignancies. We report a new case of melanoma in a dark-blue tattoo and we review all cases of melanoma reported in the medical literature from 1938 to date. Pubmed and Google Scholar were searched using the terms "melanoma tattoo", "tattoo skin tumour" and "ink melanoma". In most cases, the melanoma occurred on dark blue (10/30), black (8/30), or blue ink (3/30). The Breslow thickness at diagnosis was ≤1 mm in 13/30, 1-2 mm in 3/30, 2-4 mm in 2/30, >4 mm in 5/30, and Clark II in 2/30 (not available in 5/30). Both the incidence of melanoma and the number of tattoos have been increasing in recent years, but a possible carcinogenic effect of tattoos remains unproven. The spread of this decorative custom will make observation of melanoma in tattoos more frequent in dermatological practice, therefore these cases should be reported in national skin cancer registries.