JMIR Publications

ABSTRACT

Nontuberculous mycobacterial tattoo infections have been increasingly reported in recent years. Clinically, nontuberculous mycobacterial infections can present in a variety of ways, including papular, pustular, nodular, and abscess-like morphologies. We report the case of an immunocompetent 28-year-old male who presented with diffusely distributed monomorphic papules with collarettes of scale confined to recently tattooed skin. Histopathologic evaluation demonstrated an atypical lichenoid vacuolar interface dermatitis, and tissue culture ultimately confirmed infection with Mycobacterium abscessus complex following prolonged incubation. This case highlights the diagnostic challenges posed by atypical clinical and histopathologic features of tattoo-associated nontuberculous mycobacterial infections and emphasizes the importance of early biopsy, mycobacterial culture, and prolonged combination antimicrobial therapy for optimal patient outcomes.