BMJ Case Reports 2018; doi:10.1136/bcr-2017-222762
  • Reminder of important clinical lesson

Cutaneous Mycobacterium massiliense infection from tattooing: a common yet under-reported and persistent epidemic hazard for dermatologists

  1. Stanton Wesson2
  1. 1College of Medicine, University of Florida, Gainesville, Florida, USA
  2. 2Department of Dermatology, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Lymaries Velez, lymaries{at}
  • Accepted 1 January 2018
  • Published 12 January 2018


Tattoo popularity continues to rise, with 3 in 10 Americans bearing at least one. Among tattoo complications, non-tuberculous mycobacteria (NTM) has emerged as a global public health concern. NTM infections associated with tattooing of immunocompetent individuals have occurred as sporadic cases and community outbreaks. Water sources are considered the major pathogenic reservoirs. Tattoo-related inoculation has been linked to contamination of ink, either during the manufacturing process or during dilution of black ink using non-sterile water. NTM infections have also been documented in a number of cosmetic and surgical procedures, including cutaneous surgery, Mohs micrographic surgery, mesotherapy, liposuction and laser resurfacing. NTM inoculation through exposure to contaminated water or non-sterile instruments remains a challenge for dermatologists and risk to patients. We reported a case of cutaneous Mycobacterium massiliense infection following tattoo placement. This report underscores the importance of clinicians to consider NTM infections in the differential diagnosis of procedure-related reactions.


  • Contributors SA and SW c, reporting and assessment of the patient and the value of their situation. LV and JH researched and wrote the manuscript. SW and SA edited and completed the final manuscript.

  • Disclaimer All authors have no relevant financial interest in this manuscript and no activities, affiliations, or relationships to disclose. This manuscript has not been previously published and is not under consideration in the same or substantially similar form in any other peer-reviewed media.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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