Fatal Phenol Toxicity Following Attempted Tattoo Removal

Tattoo removal is increasingly required as the number of, particularly young, people acquiring tattoos is increasing. A 21‐year‐old man is reported who underwent attempted removal of large dragon tattoo utilizing a tattoo machine that injected a phenol‐containing solution. At the end of the 3‐h procedure, he collapsed and died. At autopsy, large areas of white skin discoloration with focal necrosis and sloughing were present overlying areas of previous tattooing. Histological examination showed collections of eosinophilic fluid with a minimal chronic inflammatory infiltrate in better preserved areas, with focal areas of dermal necrosis. Toxicology was positive for phenol in cardiac blood and liver tissue. There were no underlying organic disease or injuries present which could have caused or contributed to death. This idiosyncratic method of tattoo removal involving subcutaneous injection of phenol had resulted in death most likely from cardiotoxicity.