HealthDay News — Malignant melanoma may develop on a preexisting nevus within a tattoo that is being removed with laser therapy, according to a case report published in JAMA Dermatology.

Laura Pohl, MD, of Laserklinik Karlsruhe in Germany, and colleagues described the first case of a malignant melanoma that formed on a preexisting nevus within a tattoo during and between phases of removal with laser therapy.

During laser removal of large, multicolored tattoos on both arms and the chest, the researchers found a suspicious mole on the right shoulder of a man aged 29 years. The mole had previously been hidden under a dark portion of the tattoos, which the patient had for 10 years before deciding to have them removed.

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Initially, the man refused to allow excision of the nevus, but consented when informed that the removal, already consisting of 47 laser treatments, could not continue unless the mole was taken off. Biopsy results showed the lesion was a superficial spreading malignant melanoma.

The study noted that there were 16 previously documented cases of malignant melanomas developing under tattoos.

While melanoma can originate in the eyes and intestines, the majority of cases begin on the skin. Rates of incidence have been rising in recent decades, and the National Cancer Institute estimates that nearly 10,000 people will die from melanoma in 2013.

It is best to treat melanoma during early stages, as cancer cells can spread under the skin and to other parts of the body if left untreated. Approximately three quarters of all deaths related to skin cancer are caused by melanoma.

The case revealed the inherent danger of getting a large tattoo.  Moles and other lesions that may prove cancerous can be hidden under the ink, making them harder to identify and treat. Moreover, subsequent laser treatment can lighten the color of the lesion, making it appear less harmful than it actually is.

“In general, tattoos should never be placed on pigmented lesions; if they are, the tattoos should not be treated by laser,” the authors wrote.


  1. Pohl L et al. JAMA Dermatology 2013;doi:10.1001/jamadermatol.2013.4901.