Beastly nodules instead of beauty: pseudoepitheliomatous hyperplasia developing after application of permanent make-up

Abstract

Ten days after application of permanent make‐up on her lips, a 55‐year‐old woman developed hard erythematous nodules with a whitish cover, on the treated area only (Fig. 1). Skin biopsy revealed irregular‐shaped rete ridges extending deep into the dermis (Fig. 2). Clobetasol ointment led to a satisfactory resolution (Fig. 3). Pseudoepitheliomatous hyperplasia may histologically mimic keratoacanthoma or squamous cell carcinoma. It is usually induced by chronic wounds or inflammation. So far, it has been described as a reaction to a tattoo, but not to the application of permanent make‐up. As this cosmetic treatment shows increasing popularity, pseudoepitheliomatous hyperplasia may be more frequently encountered as a disturbing side‐effect.