Introduction: Koebner phenomenon (KP) affects up to a third of patients with psoriasis and can occur on tattoos. Little is known about the extent of tattooing and its consequences among psoriatic patients. A survey was conducted to determine the demographics, motivations and attitudes towards tattoos, and complications among tattooed patients with psoriasis, and the impact on their body image.
Methods: Ninety Finnish patients completed an internet self-reported questionnaire in June 2016.
Results: Fifty-two percent (48/90) had one tattoo or more (mean number of three tattoos, range 1-20). They were younger than non-tattooed patients (p = 0.001). Of these, 27.6% experienced a KP on their tattoos from 1 week to 15 to 20 years after tattooing. Among those, 30% reported an acute flare-up of psoriasis within the first weeks after tattooing. They were more likely to have a history of KP. Less than 7% reported a psoriasis flare-up on another part of the body after tattooing. Eighty-two percent stated that their tattoo(s) had a positive effect on their body image.
Conclusion: KP on tattoos is not particularly frequent in patients with psoriasis. Tattooing has a bolstering effect on body image and should not be a contraindication. However, patients need proper counseling before receiving tattoos.