Cutaneous infection in a tattoo due to mycobacterium chelonae: a report of 2 cases and a review of the literature.

Patient 1 was a 33-year-old man who had had a tattoo placed on his right leg 4 years previously. Three months before consulting, he had the shield outlined in black and a gray flame added. Asymptomatic lesions appeared 2 weeks later and were treated unsuccessfully with topical corticosteroids and antibiotics. The patient was then referred to the dermatology department. Physical examination of the gray flame revealed several papulopustules measuring 1mm to 4mm in diameter (Fig. 1A). The border drawn in black ink the same day was not affected. Analysis of a biopsy specimen revealed granulomas with abscess formation (Fig. 1B); Kinyoun staining was negative. M chelonae grew in culture 15 days later. The chest x-ray was normal, and laboratory tests (including serology for HIV and hepatitis) were negative. The patient was treated empirically with clarithromycin (500mg/12 h) for 3 months. The lesions disappeared.