Accidental occupational fireworks tattoo

Domenico Bonamonte, Michelangelo Vestita, Gianni Angelini

 Department of Biomedical Science and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy

Correspondence Address:
Michelangelo Vestita
Section of Dermatology, Policlinico di Bari, Piazza Giulio Cesare, 11 - 70124 Bari
Italy

A 47-year-old man employed in the fireworks industry presented with skin lesions since 3 months, following an explosion in his factory. Cutaneous examination revealed a tattoo made up of countless tiny, deeply embedded blue particles affecting most of the face as well as the lips and the conjunctivae. He also had a subconjunctival hemorrhage in the left eye [Figure - 1].

Figure 1 : Accidental occupational fireworks tattoo

The blue color could be secondary to the dermal localization of gunpowder fragments (Tyndall effect) as well as to the specific color of copper compounds used to obtain the blue tone in "stars" fireworks. The differential diagnosis includes accidental tattoos from other causes such as asphalt, graphite and carbon. Treatment options include microsurgical excision, dermabrasion, cryo- and electro-surgery, phenol acid, and Q-switched lasers but our patient was satisfied with camouflage.