Abstract：
The popularity of tattoos has led to an increase in associated skin reactions, including complications such as infection, allergic reactions and rare conditions such as tattoo-induced cutaneous lymphoid hyperplasia (CLH). CLH is a benign lymphoproliferative reaction with clinical features resembling malignant cutaneous lymphomas. Non-invasive diagnostic tools like reflectance confocal microscopy (RCM) and the new line-field confocal optical coherence tomography (LC-OCT) are being studied in dermatology better to understand the morphological patterns of many dermatological diseases. Between September 2021 and May 2023, patients with suspicious lesions for tattoo-related CLH were analysed using RCM and LC-OCT before confirming the diagnosis of CLH through skin biopsy and histopathological examination. The study included five cases of CLH. It focused on the analysis of high-quality LC-OCT images/videos and RCM images to investigate the features of CLH in tattooed individuals. Most (80%) cases exhibited a mixed T and B lymphocyte infiltration subtype, while 20% showed a predominant T infiltration subtype. RCM and LC-OCT revealed characteristic features, including architectural disarray, fibrosis, lymphoid infiltrates, and pigment deposits in the epidermis and dermis. Non-invasive tools such as RCM and LC-OCT are valuable in diagnosing tattoo-related CLH. While skin biopsy remains the current standard for diagnosis, RCM and LC-OCT can serve as helpful adjuncts in identifying the most representative area for biopsy. They may potentially become alternative diagnostic options in the future, offering benefits in terms of cost, diagnostic efficiency, aesthetics and patient satisfaction as the prevalence of tattoo-related adverse reactions continues to rise.
摘要：
纹身的普及导致相关皮肤反应的增加，包括感染等并发症，过敏反应和罕见的条件，如纹身诱导的皮肤淋巴增生（CLH）。CLH是一种良性淋巴增生反应，其临床特征类似于恶性皮肤淋巴瘤。在皮肤病学中正在研究非侵入性诊断工具，例如反射共聚焦显微镜（RCM）和新的线场共聚焦光学相干断层扫描（LC-OCT），以更好地了解许多皮肤病的形态模式。在2021年9月至2023年5月之间，使用RCM和LC-OCT分析了纹身相关CLH的可疑病变患者，然后通过皮肤活检和组织病理学检查确认CLH的诊断。该研究包括5例CLH。它专注于分析高质量的LC-OCT图像/视频和RCM图像，以研究纹身个体的CLH特征。大多数（80％）病例表现为混合的T和B淋巴细胞浸润亚型，而20%表现为主要的T浸润亚型。RCM和LC-OCT揭示了特征，包括建筑混乱，纤维化，淋巴浸润,和色素沉积在表皮和真皮。诸如RCM和LC-OCT的非侵入性工具在诊断与纹身相关的CLH方面是有价值的。虽然皮肤活检仍然是目前的诊断标准，RCM和LC-OCT可作为确定最具代表性的活检区域的辅助手段。它们可能在未来成为替代诊断选择，提供成本方面的好处，诊断效率，美学和患者满意度随着纹身相关不良反应的患病率持续上升。
