An itchy tattoo

A 59-year-old man had a temporary blue–black tattoo on his right upper arm which he had acquired while holidaying in Thailand. Within a week, the tattoo pigment had faded, but he developed a persistent, intensely itchy, red rash that was restricted to the site of the tattoo (Figure 1). A skin biopsy showed a marked lymphocytic reaction at the epidermal junction and around the underlying vessels (Figure 2).