Researchers from the Netherlands Cancer Institute and the country’s Diakonessen Hospital noted that although dermatography (medical tattooing) is commonly performed around the world as a component of nipple reconstruction after mastectomy, it is rarely used as an adjuvant to enhance the appearance of scars and skin grafts after surgical procedures.
Indications for dermatography are numerous, the study authors noted, and include primary treatment (eg, burn scars, vitiligo, alopecia of eyebrow or scalp, port-wine hemangioma) and adjuvant treatment (eg, surgical scars, skin grafts, free flaps). Compared with surgical options to improve scar or skin transplant appearance, dermatography is minimally invasive and complications seldom occur.
To analyze the effect of dermatography on the subjective perception of the appearance of scars and skin grafts and quality of life, 56 patients undergoing dermatography in the Netherlands between 2007 and 2015 responded to two questionnaires measuring their scar or graft appearance and their quality of life before and after dermatography as an adjuvant treatment for benign or malignant head and neck tumors. The mean age of the study cohort was 56.5 years, and 42 (75%) were female.
The mean improvement in scar or skin graft perception on the visual analog scale of the modified Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty before and after dermatography was 4 points. On the modified Patient Scar Assessment Questionnaire, uniform improvement of approximately 1 point across 9 questions was observed. The answers to all patient satisfaction and quality-of-life questions on both questionnaires improved significantly after dermatography.
Researchers concluded that this is the first evidence to suggest that dermatography is an effective adjuvant procedure that improves the subjective perception of scar and skin graft appearance and the quality of life in people with head and neck cancer.
Drost BH, van de Langenberg R, Manusama OR, et al. Dermatography (medical tattooing) for scars and skin grafts in head and neck patients to improve appearance and quality of life [published online ahead of print September 22, 2016]. JAMA Facial Plast Surg.