Intended for healthcare professionals

Endgames Spot Diagnosis

Tattoo Trouble

BMJ 2017; 356 doi: (Published 19 January 2017) Cite this as: BMJ 2017;356:i6816
  1. Lorne V Mitchell, clinical fellow in dermatology1,
  2. Dawn M Caruana, locum consultant dermatologist1,
  3. Grant Wylie, consultant dermatologist2
  1. 1Walton Building, Glasgow Royal Infirmary, Glasgow, UK
  2. 2Queen Elizabeth University Hospital, Glasgow, UK
  1. Correspondence to LV Mitchell lorne.mitchell{at}

A patient presented to the dermatology department with a skin eruption over a new tattoo site (fig 1). What is the name of the phenomenon in this picture, and what is the underlying skin condition?

Fig 1 A skin eruption over a new tattoo site on the right forearm

Short answer

This patient has chronic plaque psoriasis. The development of psoriatic lesions over a new tattoo site is known as the Koebner phenomenon.


Localised skin eruption after cutaneous injury, in this case the development of psoriasis over a recent tattoo site, is described as the Koebner phenomenon.1 …

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