Tattoo sarcoidosis is a rare clinical entity that shows a sarcoidosis like granuloma developing from tattoo skin and clinical symptoms of systemic sarcoidosis after long term courses of tattoos. Hypersensitivity reaction for metal included in a pigment of tattoo pigment may assume to be the cause of tattoo sarcoidosis.
A man aged 20s developed symptoms similar to those of systemic sarcoidosis after receiving a multicolored tattoo covering the skin of his entire body. He put a tattoo (red, green, black, gray, yellow and gray) over his entire body 10 years ago. There were severely painful subcutaneous masses about 1 cm in size on a brown and green tattoo on back and lower extremities. A biopsy of the part of the nodule showed a foreign body granuloma containing multinuclear giant cells. Photophobia and decreased visual acuity developed afterwards, and he was diagnosed with bilateral iritis. In addition, hilar lymphadenopathy was founded in a chest X-ray and CT, persistent fever also showed. We diagnosed it as sarcoid reaction by the tattoo because of skin epithelioid granuloma, iritis, and bilateral hilar lympadenopathy in CT. After hospitalization, his eyes were injected with dexamethazone and he took oral prednisolone 40 mg/day for iritis. Severe iritis was not improved by administration of only steroids and improved in combinating azathioprine. We report this as the interesting case that showed a sarcoidosis like reaction to the pigment of a tattoo.
