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The physician diagnosed an allergic reaction to the red dye in his tattoo. While the reaction to the red dye made the Devil’s face look more “devilish,” (not a bad thing in the patient’s mind), the patient wanted relief from his symptoms. The physician prescribed topical clobetasol, a high-potency steroid, but there was no improvement.
At the next visit the physician recommended intralesional steroid injections. The physician injected triamcinolone 5 mg/cc with a 27-gauge needle. The erythema and swelling improved and the patient returned for more injections. After 3 rounds of injections, the erythema and swelling disappeared.
The patient indicated that this would be his last tattoo.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Usatine, R. Contact dermatitis. In: Usatine R, Smith M, Mayeaux EJ, Chumley H, Tysinger J, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:591-596.
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