Tattoo-associated HPV-induced verrucae

A 23-year-old male came to our clinic with numerous warts on his tattoo. The patient informed us that the lesions had appeared spontaneously 1 month before. He had taken several medications for the clinical condition without effect. The patient was immunocompetent. Physical examination showed abundant verrucae on the tattoo (Fig. 1). The lesions were painless to palpation, soft, of dissimilar diameter, and similar in color to skin affected. The clinical diagnosis was tattoo-associated HPV-induced verrucae, a benign disease caused by human papillomavirus subtype 27. An incisional biopsy was done. Anatomopathological analysis showed hyperparakeratosis, hypergranulosis, and koilocytic cells, which confirmed the diagnosis. The patient was treated with a topical solution of salicylic acid, lactic acid, and elastic collodion with good response. Nevertheless, it is not possible to predict when the warts will recur.

Fig. 1.

Several vulgar warts mainly confined to areas of tattoo pigment