The lady with the dragon tattoo

Background Though the skin is affected in sarcoidosis in about one-third of cases, granulomatous tattoo reactions are an unusual manifestation of the disease. It is important phenomenon to recognize, as it frequently leads to the diagnosis of systemic sarcoidosis. Case presentation A 35-year-old Cau...

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Bibliographic Details
Published in:Irish journal of medical science 2017-02, Vol.186 (1), p.157-160
Main Authors: O’Beirne, S. L., O’Dwyer, D. N., Walsh, S. M., Dodd, J. D., Crotty, T. B., Donnelly, S. C.
Format: Article
Language:English
Subjects:
Adult
Biopsy
Brief Report
Family Medicine
Female
General Practice
Granuloma - pathology
Humans
Internal Medicine
Medicine
Medicine & Public Health
Sarcoidosis - diagnosis
Skin - pathology
Skin Diseases - pathology
Tattooing
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Summary:Background Though the skin is affected in sarcoidosis in about one-third of cases, granulomatous tattoo reactions are an unusual manifestation of the disease. It is important phenomenon to recognize, as it frequently leads to the diagnosis of systemic sarcoidosis. Case presentation A 35-year-old Caucasian female with multiple tattoos presented with a 5-week history of tenderness of the black dye in a tattoo depicting a dragon. She also described a 15-month history of fatigue, polyarthralgia, and mild dyspnea. Skin biopsy demonstrated multiple dermal non-caseating granulomata with associated tattoo ink. Further investigation revealed the presence of systemic sarcoidosis. Her symptoms and skin changes improved with conservative management. Conclusion Sarcoidal tattoo reactions in those without systemic sarcoidosis are a rare occurrence, and their presence should prompt a search for systemic involvement. The accurate identification of skin involvement in sarcoidosis is important, as it tends to occur early in the course of disease, and the skin is a readily accessible site for biopsy, allowing for prompt diagnosis.
ISSN:0021-1265
1863-4362
DOI:10.1007/s11845-016-1439-1