Insect tattoos

Valeti Meghana, Hima Gopinath, Kaliaperumal Karthikeyan

 Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Puducherry University, Puducherry, India

Correspondence Address:
Hima Gopinath
Department of Dermatology, Venereology and Leprosy, Sri Manakula Vinayagar Medical College and Hospital, Puducherry University, Madagadipet - 605 107, Puducherry
India

A 62-year-old male patient presented with sudden-onset asymptomatic, multiple irregular light brown to blackish-brown macules of size varying from 0.1 to 0.7 mm on bilateral soles [Figure - 1]. The insteps were spared. There was history of him walking barefoot in his grocery shop, where there were multiple insects crawling over the floor during the monsoon season. The macules could not be removed with soap and water, but faded partially on scrubbing with acetone. A diagnosis of burrowing bug (Chilocoris assmuthi)pigmentation was made. Insects such as Kermococcus vermilis (kermes dye), Kerria lacca (lac dye), and Cochineal species (scarlet, orange, red tints) have been used as sources of dyes since ancient times. Burrowing bug produces blackish brown pigmentation when crushed. This may be due to insect pigment, ingested pigments, or the colour may be produced on exposure of insect products to the environment or the skin. This pigmentation needs to be differentiated from lentigines, petechiae, tinea nigra, and dermatosis neglecta.

Figure 1: Multiple irregular light brown to blackish brown macules of varying sizes over bilateral soles

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The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

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Conflicts of interest

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