Background/Objectives: The prevalence of tattoos has risen globally in recent decades, ranging from 10% to 29%. Although rare, melanomas arising within tattoos are challenging for dermatologists due to the complexities in clinical and dermoscopic evaluation. In this article, we report two cases of melanoma on tattoos, review the reported cases in the literature, and examine the role of reflectance confocal microscopy (RCM) in improving the diagnosis of melanoma on tattooed skin. Methods: We conducted a systematic literature search on Medline/Pubmed for the period from the inception of the databases to 31 October 2024, using the Mesh major topics ‘melanoma’ AND ‘tattoo’ OR ‘tattoo skin tumor’. Out of the 268 citations identified by our search, 37 studies met the eligibility criteria. Results: In total, 43 cases of melanoma arising on tattooed skin were identified, to which we add our 2 cases, bringing the total to 45. The most common locations were the upper limbs (53%) and trunk (38%), predominantly arisen on black and blue tattoos. Of 40 cases with known depth of invasion, 4 were in situ and 36 invasive, with a mean Breslow thickness of 2.7 mm. Seven patients had a positive sentinel lymph node. Of 16 cases with an available horizontal diameter, 12 melanomas had a diameter of ≥1 cm. Conclusions: The limited cases of ‘’melanoma on tattoos” reported in the literature suggest a coincidental association rather than a direct causal link. Nevertheless, increased awareness among patients and tattoo artists about potential risks and preventive measures may enhance the management of melanocytic lesions in tattooed individuals. Lastly, integrating reflectance confocal microscopy with dermoscopy increases the overall diagnostic accuracy for melanoma, enhancing the identification of pigmented and non-pigmented skin lesions.
背景/目的：近几十年来，纹身的全球流行率持续上升，范围在10%至29%之间。尽管罕见，但纹身内发生的黑色素瘤因其临床和皮肤镜评估的复杂性，对皮肤科医生构成诊断挑战。本文报告两例纹身部位黑色素瘤病例，回顾文献中已报道的案例，并探讨反射式共聚焦显微镜（RCM）在改善纹身皮肤黑色素瘤诊断中的作用。方法：我们在Medline/Pubmed数据库中系统检索了建库至2024年10月31日的文献，使用医学主题词"黑色素瘤"与"纹身"或"纹身皮肤肿瘤"进行组合检索。从检索到的268篇文献中，最终37项研究符合纳入标准。结果：共发现43例纹身部位发生的黑色素瘤病例，结合本研究的2例新增病例，总计达45例。最常见部位为上肢（53%）和躯干（38%），主要发生于黑色和蓝色纹身区域。在40例已知浸润深度的病例中，4例为原位癌，36例为浸润性癌，平均Breslow厚度为2.7毫米。7例患者前哨淋巴结阳性。在16例有水平直径记录的病例中，12例黑色素瘤直径≥1厘米。结论：文献中报道的"纹身部位黑色素瘤"病例有限，提示两者可能为偶然关联而非直接因果关系。尽管如此，提高患者和纹身师对潜在风险及预防措施的认识，可能有助于改善纹身人群黑素细胞病变的管理。最后，将反射式共聚焦显微镜与皮肤镜技术结合应用，可提高黑色素瘤的整体诊断准确率，增强对色素性和非色素性皮肤病变的识别能力。
Melanoma Arising in Tattoos: A Case Series and Scoping Review of the Literature
肿瘤(癌症)患者之家