EurAsian Journal of BioSciences Eurasia J Biosci 14, 6335-6342 (2020)

The bacterial infections and allergies associated with cases of removal by in Mosul city

Israa Nadhim Lateef 1, Farah Younus Hussein 2, Hiyam Adil Ibrahim 3* 1 Assist. Lect., College of Basic Education, General Sciences Department, Mosul, IRAQ 2 Lectures, College of Basic Education, General Sciences Department, Mosul, IRAQ 3 Asist. Prof., College of Sciences, Biology Department, Mosul, IRAQ *Corresponding author: [email protected]

Abstract The study was based on the detection of bacterial infections and the allergy associated with tattoo removal. (88) persons who removed with laser were selected; their ages ranged from (18-55) years from both genders, and it was confirmed by the specialist doctor that they were not allergic; samples were collected from them by taking swabs from the area of the tattoo after its removal, and were kept in transport media, then bacteria were isolated and diagnosed. Blood samples were also taken from them to estimate the total IgE concentration to detect sensitivity. The results showed that the percentage of males who treated tattoos was (72.7%), while females was (27.3%). The second age group (26-40) years recorded the highest percentage of males and females who treated tattoo with (75%) and (33.33%) respectively. Two species of bacteria were isolated; Klebsiella and Escherichia coli. Klebsiella recorded the highest percentage (66.67%) with a significant variation among isolated species of bacteria, and the percentage of those infected with bacteria was (13.64%) compared to the non- infected (86.36%); females had the highest percentage (66.67%) of bacterial infection; all groups of age were of equal percentages of infection (33.33%), whereas the non- infected in the second group of age (26-40) years was of the highest percentage (68.42%). By detecting the allergy based on the concentration of IgE, it was found that the percentage of allergic people was (31.82%), less than the non-allergic, and males recorded the highest percentage of allergic people, and the second group of age (26- 40) years the highest percentage (71.42%) of those who were allergic. A significant difference appeared for the results above at the level of probability P≤ 0.05. Blood group O was of the highest percentage among people who treated tattoos with laser, and the highest allergic when removing the tattoos; percentage of smokers who treated tattoos was less than non- smokers and the degree of sensitivity was higher among smokers when removing the tattoos.

Keywords: tattoo removal, laser, allergies, bacterial infections, IgE, blood group

Lateef IN, Hussein FY, Ibrahim AI (2020) The bacterial infections and allergies associated with cases of Tattoo removal by laser in Mosul city. Eurasia J Biosci 14: 6335-6342.

© 2020 Lateef et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License.

INTRODUCTION teenagers and young men are considered a fashion to enhance the shape of the body, and its spread is due to A tattoo is the word “Tattua” meaning (sign); it imitating celebrities and athletes (Oinam et al., 2019). includes the process of permanently implanting pigment Italy has witnessed a continuous increase in the practice granules into the .In recent times it was used for of tattooing, despite having a law that prohibits putting cosmetic purposes among teenagers and youth tattoos on individuals under the age of eight without (Sharma et al., 2019; Kluger, 2017; Pater and Cobbs, parental consent (Renzone et al., 2018). 2015). About 10-20% of the population in western countries Medical tattoos are used as camouflage in the case has at least one tattoo. In 2009, a study was conducted of , to reconstruct the areola of the nipple after on the population of Finland and it found out that 13% of breast cancer surgery, to camouflage permanent hair the population which were between 20-30 years old had loss after craniofacial surgery, and to cover scars after tattoos (Patel and Cobbs, 2015; Kluger, 2017). In plastic and reconstructive surgeries in addition to the Australia, it was noted that tattoos are more common use of tattoos as a form of which is among men than women, especially those over the age a professional practice in beauty centres (Khunger et al., 2015). The arms, legs and back are the more common Received: September 2019 areas for making tattoos than other covered areas (Patel Accepted: April 2020 and Cobbs, 2015). In northeast India, tattoos among Printed: December 2020

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EurAsian Journal of BioSciences 14: 6335-6342 (2020) Lateef et al. of 40years, while in the United States of America, tattoos Recently, patients who seek to remove tattoos for are more common among women than men (Niederer et psychological, social, and emotional reasons have al., 2017; Serup et al., 2015). increased, especially those who have tattoos of names A dichromate dye is used for tattoos to give green or religious symbols, in addition to the presence of jobs colour, cobalt for blue colour, and cadmium for yellow that do not permit tattoo, like joining the military forces. (Khunger et al., 2015; Campisi, 2016). In recent years Removing a tattoo is a very complicated and hard black tattoos resulting from mixing henna with (P- process especially professional ones (Khunger et al., phenylenediamine) was used and it spread among 2015). children, teenager and youth in tourist resorts, especially Many ways were being used previously to remove in Turkey, Europe, Egypt, the United States, Mexico, tattoos such as minerals or coated diamond with adding Australia, Southeast Asia and South Africa (Panfili et al., wound dressings, in addition to the use of . 2017). The European Union used (PPD) in cosmetic Nowadays Q-switch laser is widely used which is and in hair dyes with a maximum considered the best way to remove tattoo except that it concentration of 6%. Black tattoos may cause acute needs a long time and on lengthy intervals for removal allergic contact dermatitis (Moro et al., 2016). (Campisi, 2016), since the laser does not remove ink Pigments responsible for red tattoos include totally but divides dyes particles making them prone to (mercury , cadmium selenide, and ferric hydrate) or attack and then moved to lymph nodes. an organic dye that includes: (sandalwood and Brazilian The energy absorbed by the tattoo’s dye is also wood) (Forbat and Al-Niaimi, 2016). Many tests were transferred to heat causing a photoelectric impact that conducted on the dyes used in tattoos in terms of their breaks chemical bonds inside the dye; the remaining degree of decomposition at high and low temperatures, dyes in the skin stimulate the immune system (Khunger their ionization under sunlight or exposure to the laser, et al., 2015; Rahimi et al., 2018). and the materials resulting from these dyes and their Then the Picosecond (10-12) laser was presented and effect on the skin of the tattooists, the thing that led to appeared to be more effective for tattoo removal; it the prohibition of many dyes (Schreiver et al., 2016). In works with shorter pulses that heat the area quickly, and 2004, P. aeruginosa bacteria and mold-Acremonium sp. with the use of extreme heat or extreme cold the surface were isolated from some inks in the market where there layer of the skin I destroyed leaving scars just like the are no internationally valid standards for the CO2 laser (Hsu et al., 2016). manufacturing of tattoo inks being neither medical, Immediate complications of laser tattoo removal cosmetic or pharmaceutical products and they contain (pain, blisters, peeling, and bleeding) occur especially in industrial pollutants, solvents, emulsions, anti-foaming darker , while late complications ( agents such as polydimethylsiloxane and preservatives or ) occur 4-6 weeks after using the such as (paraffin, phenol and methylisothiazolone and laser and may include pigment changes that remain for minerals such as nickel and chromium in addition to a long time, especially in dark skin, lack of white blood aromatic hydrocarbons (Baumler, 2016; Serup et al., cells and sensitivity may occur several months or years 2015). after removing the tattoo (Khunger et al., 2015; Campisi, Tattooing has many complications including skin 2016). complications such as (acute inflammatory skin The study aimed to prove the bacterial infection and reactions due to the use of needles, and skin diseases allergy resulted from tattoos laser removal in Mosul city. such as eczema, psoriasis, vitiligo, lupus erythematosus, lichen planus, hypersensitivity to tattoo MATERIALS AND METHODOLOGY ink, skin cancer, aspergillosis, and granuloma), and 88 people of both sexes, who had their laser tattoos systemic complications such as (Sarcoid infection in removed, were selected; their ages ranged from (18-55) eyebrows and lips tattoos (Kluger, 2017; Rahimi et al., years, and they were checked by the specialist doctor 2018; Khunger et al., 2015; Forbat and Al-Niaimi, 2016). for not being allergic. Samples were collected from these Causes of infection after tattooing are The use of people for the period from September 2018 to contaminated dyes, lack of good disinfection of the skin September 2019, including taking swabs from the tattoo area, and the development of itching and burning area after removal and was preserved in a transport increase the risk of infection in the tattooed area medium to be transported to the research laboratory in (Khunger et al., 2015). As for the bacterial infection of the College of Basic Education / General Sciences. the tattoo, it includes (Clostridium tetani, Treponema Laboratory tests were performed where samples were pallidum, Mycobacterium leprae, Staphylococcus grown on blood agar and MacConkey agar and aureus, Pseudomonas aeruginosa, and Streptococcus incubated at 37 ° C for a period of (24-48) hours, then pyogenes, ), fungal infection includes (Epidermophyton the diagnostic tests for bacteria were performed floccosum, Candida albicans, and, Zygomycota, ), and according to (Procop et al., 2017). viral infection includes (HCV, HBV, HIV, Herpes) (Show et al., 2019; Patel and Cobbs, 2015; Serup et al., 2015).

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Table 1. The percentage of males and females who treated Table 3. Percentages of bacteria species isolated from their tattoos tattoo removal cases Gender Male Female Bacteria isolated Escherichia col Klebsiella Total Number 64 24 Number 4 8 12 Percentage 72.7% 27.3% Percentage 33.33% 66.67% 13.64%

Table 2. Percentages of age and gender groups relation Table 4. The relation between bacterial infection and after removing tattoos gender, after tattoo removal First category of Second category Third category of Gender Infected Non- infected Gender age (18-25) of age (26-40) age (41-55) Males 4 (33.33%) 60 (78.95) male 8 (12.5%) 48 (75%) 8 (12.5%) Females 8 (66.67%) 16 (21.05%) Female 4 (16.67%) 8 (33.33%) 12 (50%) Total 12 (13.64%) 76 (86.36%)

Blood samples were collected via a medical syringe, Table 2 show that the highest percentage of people a portion of blood was placed inside serum tubes and who go to remove tattoos is the second group of age, precipitated by a centrifuge device at a speed of (300) where males represent 75% and females 33.33%. A revolutions /minute. The serum was separated and the significant difference appeared for this group of age with serological tests, which included measuring the gender after removing the tattoo at a probability P ≤ 0.05, concentration of total IgE were carried out using the and the reason is that people over the age of 25 are the ELISA method, via a kit manufactured in Australia and most attracted by tattoos, and this is what (Hsu et al., equipped by (DIALAB, 2018) company. 2016) pointed out. In America, nearly third of Americans The other portion of the blood was placed in a test of ages (18-25), and 40% of Americans of ages of (26- tube containing ethylene diamine tetra acetic acid, and 40), put tattoos. eosinophils were counted by dyeing the blood slice with Table 3 show that the bacteria isolated from those Leishman stain and counting the number of eosinophils that treated tattoos with laser were Escherichia coli and per 100 white cells (Mohamed and Ismail, 2018). Klebsiella with percentages of (33.33%, 66.67%) A blood group test was performed using the kit respectively, in twelve patients, and there was a provided by Rapid Labs Company by taking a drop of significant difference between the isolated bacteria blood and adding antibody and determining blood group types, but in another study, E. coli, Staphylococcus by observing clumping (United Kingdom, 2018). aureus and Pseudomonas aeruginosa were isolated Statistical Analysis from about 39 ink samples in Germany, and after The standard statistical method was adopted to find injecting these inks into the skin during tattooing, the number and the percentage in addition to the use of infection with these types of bacteria occurs (Dieckmann Z and X2 tests in comparisons to find the significant et al., 2016). difference and the results of significance tests at a Table 4 show that the percentage of people not probability level P≤ 0.05 (MacFarland and Yates, 2016). infected with bacteria after tattoo removal was (86.36%) which is higher than the percentage of people infected RESULT AND DISCUSSION with bacteria (13.64%), and there is a significant effect between infection with bacteria and gender at a From Table 1 we note that: The number of males is probability level P≤ 0.05, and this result is due to the use more than females, as the percentages of males and of local anesthesia cream to avoid laser pain and females reached (72.7% and 27.3%), respectively, so applying a broad-spectrum antibacterial ointment there is a significant difference between the percentages immediately after removing the tattoo (Kuperman et al., of males and females. Despite the spread of tattoos in 2001). Researchers (Liu and Huo, 2011) reported a 36- recent years, which has been met with great demand by year-old Mongolian woman not suffering from any skin men, the number of those who wish to remove tattoos lesions and to provide protection from laser treatment, has increased due to dissatisfaction and boredom with Lidocaine 2% anesthetic was applied to the area of the tattoos or for religious reasons increased, however, tattoo, and after removal, an anti-bacterial ointment was removing tattoos in men constitutes a high percentage used for seven days; the patient did not suffer from any due to occupational and social pressures, as some bacterial infection. The validity of these results are occupations reject tattoo because it gives a bad confirmed by the findings of (Pinheiro et al., 2020); when impression of the one who has it, in addition to the cultivating 3.32 μg / ml of Enterococcus faecalis and tendency of prisoners who have been qualified to Staphylococcus aureus bacteria and exposing them to remove tattoos for the purpose of their blending with laser for 5 minutes before incubation, the results showed society (Isaacs et al., 2018). Males being of the highest a decrease in the number of bacteria by 99.97%. Table percentage in tattoo removal indicates that males are 4 shows that bacterial infection in females is (66.67%) more apt to tattooing, and this is what (Serup et al., and this is higher than males, and this does not agree 2015) indicated, that in Australia, tattoos are more with a study conducted by (Jaillon et al., 2019), which spread among males than females.

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Table 5. The relation between bacterial infection and age Table 7. The percentages of allergy and age relation after group, after tattoo removal tattoo removal depending on the number of Eosinophils in Age Infected Non- infected blood First age group (18-25) 4 (33.33%) 8 (10.53%) Age Allergic Non- allergic Second age group (26-40) 4 (33.33%) 52 (68.42%) First age group (18-25) 4 (14.29%) 8 (13.33%) Third age group (41-55) 4 (33.33%) 16 (21.05) Second age group (26-40) 20 (71.42%) 36 (60%) Total 12 (13.64%) 76 (86.36%) Third age group (41-55) 4 (14.29%) 16 (26.67%) Total 28 (31.82%) 60 (68.18%)

Table 6. The percentage of the relation of allergy and gender with the removal of tattoos depending on the ratio Table 8. Percentages of allergy and gender relations with of Eosinophils in the blood the removal of tattoos depending on the concentration of Gender Allergic Non- allergic IgE Males 28 (100%) 36 (60%) Gender Allergic Non- allergic Females 0 (0%) 24 (40%) Males 28 (100%) 36 (60%) Total 28 (31.82%) 60 (68.18%) Females 0 (0%) 24 (40%) Total 28 (31.82%) 60 (68.18%) concluded that females are less likely to be infected with many types of bacterial, viral, parasitic and fungal examination was conducted based on the number of infections compared to males. The study of (Mishra et eosinophil and females showed the highest percentage al., 2014) which included 2556 patients (1480 males and (96%) than males (31%). Doctors advise people who 1076 females) with various skin diseases indicated that suffer from allergy when removing tattoos by laser to the rate of bacterial infection in males was higher than resort to surgical methods for this purpose (Berstein, that of females. 2007). Table 5 show that: the second age group recorded Table 7 show that the second age group constituted the highest percentage (68.42%), then the third age the highest percentage (71.42%), then followed the first group (21.05%) of the uninfected, and there is a and third age groups in equal proportions of allergic significant effect of age on infection with bacteria or no people, and there is a significant effect of age on allergy infection at the level of P≤0.05, as for those infected with depending on the number of eosinophils at the bacteria, the first, second and third groups recorded probability level P≤0.05 and this does not agree with the equal percentages of (33.33%), while (Mishra et al., results reached by Teague et al., (2018), that the 2014) found that bacterial infections were (13.3%) in the number of eosinophils is higher at young ages and age group (1-10). decreases at older ages. As for (Klink et al., 1990), it was Kelly et al. (1990) noted that the number of concluded that the number of eosinophils proportionally eosinophils increases with the increase in the level of increases with age, and this was confirmed by allergy, due to the leakage of these cells into the blood (Geristsen et al., 1990), as it was found that the number vessels and then into the skin as these cells dissolve and of eosinophils increased in adults compared to children. secrete the proteins inside the cells causing redness and Immunoglobulin E is mainly used to diagnose allergy itching in addition to damage of the epithelial cells (Al- (Carosso et al., 2007), Table 8 indicate that the Khalifa, 2004). percentage of people who were allergic based on IgE Table 6 show that the percentage of those who are was (31.82%) and this is less than the percentage of allergic was (31.82%) and this is less than the non-allergic (68.18%). The researchers (Hibler and percentage of non-allergic ones which was (68.18%) Rossi, 2015) mentioned in their study that some tattoo and this does not agree with what the researchers dyes have negative reactions after removal by laser; one (Serup and Bäumler, 2017) noted of the development of of the patients did not suffer from allergic diseases allergy in many of those that treated tattoos with the before removing the tattoo, but after three days of laser. Table 6 show that the rate of allergy in females removing it, he became short of breath and was admitted was zero, and there is a significant effect of gender on to the hospital. Table 8 show that the percentage allergic developing allergy at a probability of P≤0.05 and this is males based on IgE was (100%), while the percentage in agreement with (Hibler and Rossi, 2015), where the of females was (0%), and there was a significant effect researchers indicated that only one woman, out of 100, of gender on allergy based on the concentration of IgE 000 laser tattoo removal procedures, developed allergy at a probability level of P≤ 0.05, which is consistent with In a spot away from the area where the tattoo was (Al-Layla, 2017), where the percentage of males was removed, and after conducting tests for her, she did not (47%), higher than the percentage of females which was show an increase in the number of eosinophilia, this (45%). It is noticed that the results are consistent with study agrees with Tegue et al., (2018), where it was Table 6 which illustrated the relationship of allergy to demonstrated that when males have an allergy, the gender depending on the number of eosinophils, and number of eosinophils increases more than in females, this was explained by (Klink et al., 1990) that there is a and this result contradicts the results reached by the relationship between eosinophils and the level of study of Goldman et al., (2017) where allergy immunoglobulin IgE.

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Table 9. Percentages of allergy and age relation after tattoo Table 12. Percentages of smokers who treated tattoos removal based on the concentration of IgE Smoker/non- smoker smoker Non- smoker Number 32 (36.36%) 56 (63.64%) Age Allergic Non- allergic First age group (18-25) 4 (14.29%) 8 (13.33%) second age group (26-40) 20 (71.42%) 36 (60%) Third age group (41-55) 4 (14.29%) 16 (26.67%) Table 13. The relation between allergic people who treated total 28 (31.82%) 60 (68.18%) tattoos by laser, and smoking

Type of allergic Smoker allergic Non- smoker allergic Number 16 12 Table 10. Percentages of blood groups for those treated for Percentage 57.14% 42.86% tattoo removal Blood group A B AB O Percentage 16 (18.2%) 12 (13.6%) 8 (9.1%) 52 (59.1%) to skin allergies (Dahalan et al., 2020). In the current

study, blood type O recorded the highest incidence of Table 11. The relation between blood group and allergy allergy after tattoo removal (71.42%), whereas type B when treating tattoos with laser did not report an allergy. As for groups A and AB, the Blood group A B AB O rate of allergies was equal in both (14.29%), as shown Allergic 4 0 4 20 in Table 11. Percentage 14.29% 0% 14.29% 71.42% Table 12 show that: percentage of smokers who removed tattoos by laser was (36.36%) and this is less It is evident from Table 9 that: the percentage of than non- smokers (63.64%), and there is a significant those who were allergic based on IgE was (31.82%) and difference between smokers and non- smokers and this this less than the percentage of those who were not proves that non- smokers have more tendency to allergic which was (68.18%), and the second age group remove tattoos, and that people with tattoos on their recorded the highest percentages of allergic and non- bodies have unhealthy daily habits like smoking allergic persons; (71.42%) and (60%) respectively, and (Mortensen et al., 2019). a significant difference was noticed at a probability level Studies have shown an association between P≤ 0.05, and the presence of a relationship between the smoking and the risk of developing allergic rhinitis and number of eosinophils and the concentration of IgE allergic dermatitis in general. In developed countries (Klink et al., 1990) explains the consistency of the results smoking is the reason for 14% of allergic rhinitis and with Table 8. 13% of allergic dermatitis (Saulyte et al., 2014). Table Many studies have shown the relation between 13 shows that percentage of allergic smokers treated people behaviors and blood groups; (Venkatesh et al., with laser was (57.14%) which is higher than the 2015) mentioned that blood group O+ is the most percentage of allergic non-smokers (42.86%) and there common whereas AB- is rare. Table 10 shows that blood was a significant difference between allergic smokers group O was seen to be of the highest percentage and allergic non- smokers. among those who treated tattoos with (59.1%), and then As a result of the health damage associated with follows group A with (18.2%). tattoo removal, this process must be carried out by a ABO antigens are associated with some human specialist doctor and the use of topical antibiotics or diseases such as malignant tumors and respiratory wound dressings after laser removal (Berstein, 2015), in diseases; severe asthma was noticed to be associated addition to that, implementing educational programs for with phenotype B, mild asthma with phenotype A and O, all age groups, especially teenagers, about the dangers and allergic rhinitis with phenotype O. ABO antigens are of tattoos and the damages that occur either while composed of complex carbohydrate molecules on the drawing it on the body or after removing it with laser surface of erythrocytes (Uwaezuoke et al., 2018). (Ayanlowo et al., 2017). The majority of studies showed that blood type O was more related to allergic rhinitis disease and less related

REFERENCES Al-Khalifa FYHZ (2004) Atopic Allergy to Allergens, Relation to Urinary Tract Infection and Level of Total and Specific IgE and Percentage of Eosinophilis of Individuals in Nineyah Governorate, M. Sc. Thesis, Mosul, University. Iraq. http://thesis.mandumah.com/Author/Home?author Al-Layla EAH (2017) Detection of Bacterial Etiology of Chronic Rhinosinusitis and its Ability to Produce Silver Nanoparticles and Molecular Detection of mrk A Gene. Ph. D. thesis, College of Science, Mosul, University Iraq. Ayanlowo OO, Gold- Olufadi SA, Akinkugbe AO, Otrofanowei E, Nga CN, Olumide YM (2017) Growing trend of tattooing and its complications in Nigeria. International Journal of Dermatology 56: 709- 714. https://onlinelibrary.wiley.com/doi/abs/10.1111/ijd.13521 Baumler W (2016) Tattoos and Their Potential Health Consequences. Deutsches Arzteblatt International 113: 663- 664. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400116/

6339

EurAsian Journal of BioSciences 14: 6335-6342 (2020) Lateef et al.

Berstein EF (2015) A widespread allergic reaction to black caused by laser treatment. in Surgery and Medicine 47: 180- 182. https://onlinelibrary.wiley.com/doi/abs/10.1002/lsm.22319 Berstein EF (2007) Laser Tattoo Removal. Seminars in Plastic Surgery 21: 175- 192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884836/ Campisi M (2016) Complications of tattoos and tattoos removal: state- of- the art in Italy. Journal of Health and Social Sciences 1: 105- 112. https://journalhss.com/wp-content/uploads/JHHS12105-112.pdf Carosso A, Bugiani M, Migliore E, Anto JM, DeMarco R (2007) Reference Valuse of Total Serum IgE and Their Significance in the Diagnosis of Allergy in Young European Adults. International Archives of Allergy and Immunology 142: 230- 238. https://www.karger.com/Article/Abstract/97025 Dahalan NH, Tuan Din SA, Binti Mohamad SM (2020) Association of ABO blood groups with allergic diseases: a scoping review. BioMedical Journal 10: 1-8. https://bmjopen.bmj.com/content/10/2/e029559.long Dieckmann R, Boone I, Brockmannn SO, Hammerl JA, Kolb- Maurer A, Goebeler M, Luch A, Al-Dahouk S (2016) The Risk of Bacterial infection after Tattooing A systematic Review of the Literature. Deutsches Arzteblatt International 113: 665- 671. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290255/ Forbat E, AL- Niaimi F, (2016) Patterns of Reactions to Red Pigment Tattoo and Treatment Methods. Dermatology and Therapy 6: 13- 23. https://link.springer.com/article/10.1007/s13555-016-0104-y Geristsen J, Koeter H, Monchy R, Knol K (1990) Allergy in subjects with asthma from childhood to adulthood. Journal of Allergy and Clinical Immunology 85: 116-125. https://www.sciencedirect.com/science/article/abs/pii/009167499090232S Goldman M, Hirsch I, Zangrilli JG, Newblod P, Xu X (2017) The association between blood eosinophil count and benralizumab efficacy for patient with severe, uncontrolled asthma: subanalyses of the Phase lll SIROCCO and CALIMA studies. Journal Current Medical Research and Opinion 33: 1605- 1613. https://www.tandfonline.com/doi/full/10.1080/03007995.2017.1347091 Hibler BP, Rossi AM (2015) A case of delayed anaphylaxis after laser tattoo removal. Journal The American Academy of Dermatology 1: 80- 81. https://www.jaadcasereports.org/article/S2352-5126 (15)00037-5/abstract Hsu VM, Aldahan AS, Mlacker S, Shah VV, Nouri K (2016) The picosecond Laser for tattoo removal. Lasers in Medical Science 31:1733- 1737. https://link.springer.com/article/10.1007%2Fs10103-016-1924-9 Isaacs T, Ngwanya RM, Lehloenya RJ (2018) Tattoos: A summary Knowledge for the practising clinician. South African Medical Journal 108: 714- 720. http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256- 95742018001000013 Jaillon S, Berthenet K, Garland C (2019) Sexual Dimorphism in Innate Immunity. Clinical Reviews in Allergy & Immunology. 56: 308- 321. https://link.springer.com/article/10.1007/s12016-017-8648-x Klink M, Cline MG, Halonen M, Burrows B (1990) Problems in defining normal limits for serum IgE. Journal of Allergy Clinical Immunology 85: 440- 444. https://www.sciencedirect.com/science/article/abs/pii/009167499090153U Khunger N, Molpariya A, Khunger A (2015) Complications of Tattoos and Tattoo Removal: Stop and Think Before you ink. Journal of Cutaneous and Aesthetic Surgery 8: 30-36. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411590/ Kluger N (2017) National Survey of health in the Tattoo industry: Observational study of 448 French Tattooists. International Journal of Occupational Medicine and Environmental Health 30: 111- 120. https://helda.helsinki.fi/bitstream/handle/10138/178731/National_survey_of_health.pdf?sequence=1 Kluger N (2017) Cutaneous Complications Related to Tattoos: 31 Cases from Finland. Dermatology 233: 100-109. https://www.karger.com/Article/Abstract/468536 Kuperman – Beade M, Levine VJ, Ashinoff R (2001) Laser Removal of Tattoo. American Journal of Clinical Dermatology 2: 21- 25. https://link.springer.com/article/10.2165/00128071-200102010-00004 Liu X, Huo M (2011) Permanent leukotrichia after Q- swiched 1064nm laser tattoo removal. Indian Journal of Dermatology, Venereology and Leprology. 77: 81- 82. https://www.ijdvl.com/article.asp?issn=0378- 6323;year=2011;volume=77;issue=1;spage=81;epage=82;aulast=Liu MacFarland TW, Yates JM (2016) Introduction to Nonparametric Statistics for the Biological Sciences Using R. Switzerland: Springer International Publishing. https://link.springer.com/book/10.1007%2F978-3-319-30634-6 Mishra N, Srivastava N, Gahalaut, P, Rastogi MK (2014) Pattern of dermatological disorders in a private skin clinic of Rohilkhand region in India. Journal of Pakistan Association of Dermatologists. 24: 138- 142. http://jpad.com.pk/index.php/jpad/article/view/193

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Mohamed SA, Ismail SN (2018) Study some biochemical and blood criteria in aborted women with toxoplasmosis in Tikrit city. Tikrit Journal of Pure Science 23: 32- 37. https://www.iasj.net/iasj/article/151794 Moro PA, Morina M, Milani F, Pandolfi M, Guerriero F, Bernardo L (2016) Senstization and Clinically Relevant Allergy to Hair Dyes and clothes from Black Henna Tattoos: Do People Know the Risk? An Uncommon Serious Case and a Review of the Literatura. Journal Cosmetics 3:1-23. https://www.mdpi.com/2079-9284/3/3/23 Mortensen K, French MT, Timming AR (2019) Are tattoos associated with negative health- related outcomes and risky behaviors?. International Journal of Dermatology 58: 816- 824. https://onlinelibrary.wiley.com/doi/abs/10.1111/ijd.14372 Niederer M, Hauri U, Kroll L, Hohl C (2017) Identification of organic Pigments in tattoo inks and permanent make – up using laser desorption ionization mass spectrometry. Journal F1000Research 6:20- 34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728192/ Oinam J, Singh AB, Singh YN (2019) Prevalence of tattooing and knowledge about health risk associated with it among adolescent school students in Manipur, North_ eastern India: across- sectional study. International Journal of Community Medicine and Public Health 6: 774- 779. https://imsear.searo.who.int/handle/123456789/201007 Panfili E, Esposito S, Cara GD (2017) Temporary Black Henna Tattoos and Sensitization to para phenylenediamine (PPD): Two Paediatric Case Reports a Review of the Literature. International Journal of Environmental Research and Public Health 14: 1- 8. https://www.mdpi.com/1660-4601/14/4/421 Patel M, Cobbs CG (2015) Infections from Body Piercing and Tattoos. Microbiol. Spectrum. 3: 1- 13. file:///C:/Users/hp/Desktop/Tattoo/tt/patel%20and%20cabbs.pdf Pinheiro ALB, Sampaio FJ P, Santos DA, Crugeira PJL, Oliveira SCPS, Monteiro JSC, Fagnani SRCA, Nunes IPF, Soares LGP, Almeide PF (2020) Nanocentrations of 1, 9- dimethylmethylene blue (DMMB) associated to laser, LED or Polarized light are highly effective on AmPDT carried out in aerobes and aerotolerant anaerobes Gram- positive bacteria. SPIEDigitalLibrary.org/conference-proceedings-of-spie. file:///C:/Users/hp/Downloads/112210P.pdf Procop GW, Church DL, Hall GS, Koneman EW, Schreckenberger PC, Woods GL (2017) Koneman, s Color Atlas & Textbook of Diagnostic Microbiology 17th: China: Wolters Kluwer: 1606pp. https://books.google.iq/books?hl=ar&lr=&id=HF3sDwAAQBAJ&oi=f Rahimi IA, Eberhard I, Kasten E (2018) Tattoo: What Do People Really Know About the Medical Risks of Body Ink?. The Journal of Clinical and Aesthetic Dermatology 11: 30- 35. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868782/ Renzoni A, Pirrera A, Novello F, Lepri A, Cammarata P, Taarantino C, Ancona FD, Perre A (2018) The Tattooed population in Italy: a national survery on dermography., characteristics and perception of health risks. Annali dell Istituto Superriore di Sanita 54: 126- 136. https://annali.iss.it/index.php/anna/article/view/543 Saulyte J, Regueira C, Montes- Martinez A, khudyakov P, Takkouche B (2014) Active or Passive Exposure to Tobacco Smoking and Allergic Rhinitis, Allergic Dermatitis, and Food Allergy in Adults and children: A Systematic Review and Meta- Analysis. PLOS MEDICINE 11: 1- 30. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001611 Schreiver I, Hutzer C, Andree S, Laux P, Luch A (2016) Identification and predication of tattoo pigments by means of pyrolysis- gas chromatography/ mass spectrometry. Archives of Toxicology 90: 1639- 1650. https://link.springer.com/article/10.1007/s00204-016-1739-2 Serup J, Bäumler W (2017) Guide to Treatment of tattoo Complications and Tattoo Removal. Current Problems in Dermatology 52: 139- 229. https://www.karger.com/Article/Abstract/452966 Serup J, Kluger N, Baumlar W (2015) Tattooed Skin and health. Current Problems in Dermatology 48: 6- 20. https://library.oapen.org/handle/20.500.12657/25856 Serup J, Kluger N, Baumler W (2015) Survery of studies on Microbial Contamination of marketed Tattoo inks Tattooed skin and Health. Current Problems in Dermatology 48: 190- 195. https://library.oapen.org/handle/20.500.12657/25856 Sharma S, Kumari K, Makhni R (2019) Tattoo Removal using Surgical Techniques: Experience with 350 Cases. International Journal of Scientific Study 6: 123-129. https://www.ijss- sn.com/uploads/2/0/1/5/20153321/23_ijss_feb_oa23_-_2019.pdf Show KL, Win LL, Saw S, Myint CK, Than KM, Oo YTN, Wai KT (2019) Knowledge of potential risk of blood- brone viral infections and tattooing practice among adults in Mandalay Region, Myanmar. Journal PLOS ONE 14: 1- 10. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0209853

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EurAsian Journal of BioSciences 14: 6335-6342 (2020) Lateef et al.

Teague G, Phillips BR, Fahy JV, Wenzel SE, Fitzpatrick AM, Moore WC, Hastie AT, Bleecker ER, Meyers DA, Peters SP, Castro M, Coverstone AM, Bacharier LB, Ly NP, Peters MC, Denlinger LC, Ramratnam S, Sorkness RL, Jarjour NN (2018) Baseline Features of the severe Asthma Research Program (SARPIII) Cohort: Differences with age, The Journal of Allergy and Clinical Immunology In Practice. 6: 545- 554. https://www.sciencedirect.com/science/article/pii/S2213219817305263 Uwaezuoke SN, Eze JN, Ayuk AC, Ndu IK (2018) ABO histo- blood group and risk of respiratory atopy in children: a review of published evidence. Pediatric Health Medicine and Therapeuticus 9: 73- 79. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6067593/ Venkatesh M, Vitthal K, Dundesh M, Ambuj J, Shilpa M, Komal R (2015) Pattern of Fingerprints in Different ABO and Rh Blood Groups. Journal of Indian Academy of Forensic Medicine. 37: 124- 126. http://www.indianjournals.com/ijor.aspx?target=ijor:jiafm&volume=37&issue=2&article=002

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