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Traumatic tattoo in Adult
Other Resources UpToDate PubMed

Traumatic tattoo in Adult

Contributors: David Brodell MD, Susan Burgin MD
Other Resources UpToDate PubMed


A traumatic tattoo is when foreign bodies become forcibly embedded in the dermis and create a permanent tattoo. Such particles may include fireworks, sand, metal, glass, gunpowder, asphalt, dust, petroleum products, and graphite from pencil point injuries. Traumatic abrasions (such as after a road accident) are a more frequent cause of traumatic tattoos than explosions. Minor trauma, such as from penetration of a pencil through the epidermis, may also be responsible.

Particles become trapped beneath healing dermis and epidermis. In explosion injury, particles may also become trapped behind a collapsed entry wound. Body location of the tattoo depends on where the trauma occurred. Lesions vary widely in size and shape depending on the causative injury, and are usually blue, gray, or black.


L81.8 – Other specified disorders of pigmentation

840343009 – Iatrogenic tattoo
840347005 – Occupational tattoo

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

The differential diagnosis may depend on the foreign body color, shape, size, and mode of entry into the skin, and includes:
  • Blue nevus or eruptive blue nevi
  • Combined nevus
  • Atypical nevus
  • Pigmented Spindle cell nevus
  • Glomus tumor
  • Venous lake or Angiokeratoma
  • Sclerosing hemangioma
  • Nevus of Ota or Nevus of Ito
  • Primary and metastatic Melanoma – easily mistaken for carbon stain (embedded graphite)

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Last Reviewed:06/07/2017
Last Updated:03/26/2017
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Traumatic tattoo in Adult
A medical illustration showing key findings of Traumatic tattoo : Abrasion, Hyperpigmented patch
Clinical image of Traumatic tattoo - imageId=5269946. Click to open in gallery.  caption: 'A bluish-black papule on the cheek.'
A bluish-black papule on the cheek.
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