Tattoo skin reaction as a skin manifestation of systemic sarcoidosis

Abstract

A 41-year-old man presented with itching of the skin surrounding his tattoos, blurred vision, fever, general fatigue, and arthralgia. Physical examination revealed skin bulges confined to the tattoo ink lines. Histological analyses of the skin revealed non-caseating granulomas surrounding the tattoo inks. Together with other clinical manifestations including uveitis, lymph nodes swelling, and elevated serum angiotensin-converting enzyme and lysozyme, he was diagnosed with systemic sarcoidosis. The administration of prednisolone alleviated the sarcoidosis-related symptoms, including skin changes. This case illustrates that skin changes on tattoos can be a presenting manifestation of systemic sarcoidosis and that skin biopsy is useful in early diagnosis.

Keywords:

• Sarcoidosis
• tattoo
• cutaneous sarcoidosis
• corticosteroid
• skin biopsy

Acknowledgments

The authors thank Dr. Kunihiro Omonishi (Department of Pathology, Fukuyama City Hospital) for useful discussion. The authors thank Enago for English editing.

Patient consent

Written informed consent for this case report was obtained from the patient.

Ethical approval

Not applicable.

Conflict of interest

None.