I i i 6 EDITORIALS Annals of Internal Medicine The Case of the Itching Tattoo

THE TATTOOED LADY, that legendary attrac-tion of the circus, had better keep out of the sun—she might get the itch. For years it has been known that tattoos containing red pigment may develop an itching eczema, warty nodules, and even sarcoid-like granulomas. Be-cause the red pigment employed in the main by tattoo artists is cinnabar—mercuric sulfide —this allergic reaction usually has been as-sumed to be a manifestation of mercurial hypersensitivity set off by a subsequent ex-posure to mercury in any of a variety of forms (1). But such exposure has often been hard to establish, and concomitant systemic sarcoidosis has never been proved; thus, the cause of the reaction in such cases has remained somewha