We read the letter to the editor, Viral warts and seborrheic keratosis on tattoos: a review of 9 cases with great interest.1 Dermatologists see only what they know! Once we recognized the possibility that warts might grow preferentially in black and blue tattoo dye, we collected 7 cases over a 10-year period from one solo private practice. In this report, a patient with a pre-existing viral wart on skin adjacent to a new tattoo appears to have preferentially spread onto the immunocompromised district (Ruocco, 2009)2 created by black ink nanoparticles. This article is protected by copyright. All rights reserved.