Use of Lasers for Iron-Induced Accidental Tattoos: Experience at a Tertiary Referral Center.

BACKGROUND: Awareness of accidental tattoos after iron injections with paravenous leakage is low. No larger patient cohorts have been analyzed. The lesions are a burden to the patients. The only known treatment is laser therapy.

OBJECTIVE: To characterize the clinical appearance and development of iron-induced tattoos and to demonstrate safe and efficient removal with quality-switched (QS) and picosecond lasers.

MATERIALS AND METHODS: The authors conducted a retrospective systematic analysis on patients who presented at the Dermatology Department of the University Hospital of Zurich between Year 2008 and 2017 with accidental hyperpigmentations after iron injections. From 29 collected patients, 13 received laser treatment and were analyzed with reference to the lasers used, including wavelength, fluence, spot size, intervals, number of sessions, and overall success. The authors defined the latter as a complete removal or as patients' satisfaction.

RESULTS: The authors treated 13 patients and completed the treatment in 8 patients, with an average of 5.6 sessions. No complications occurred.

CONCLUSION: Spontaneous regression of iron-induced tattoos is possible within 1 to 2 years, but not guaranteed. Removal with QS ruby, Nd:YAG, and picosecond lasers can be achieved within a mean number of 5.6 sessions. Assuring a valid indication before intravenous iron administration is important.