Tattooing Granuloma: Upsurging Cases as an Early manifestation of Sarcoidosis
Keywords:
Tattoo, Granuloma, Sarcoidosis, Granulomatous disease, Eyebrow, Naked granulomaAbstract
Background: Cutaneous manifestations of sarcoidosis may occur secondarily by a precipitating factor such as scars, infections, or even tattoo ink. Tattoo pigment can precipitate many inflammatory states; however, cutaneous sarcoid granuloma is a rare reaction. Objectives: To record all cases of tattooing granuloma and do a full evaluation regarding the clinical and histopathological pictures. Methods: This is a case series descriptive study where all cases with tattooing granuloma were collected during the period from 2021-2023. Full demographic and clinical evaluations were done. A complete physical checkup was carried out, especially the chest and eyes examination. Biopsies for histopathological assessment were performed. Results: Fourteen female patients were subjected to the present work, their ages ranged from 22-48 years with a mean ±SD of 32±38.7 years. All gave a history of tattooing using mostly black ink and a rash appeared a few months to one year after the procedure. Almost all patients noticed swelling and itching. The sites of tattooing were located on both eyebrows except for 2(14.3%) patients, where their tattooing was located on the upper arms and trunk. Three patients had extra-eyebrows granulomatous rash involving the trunk. One (7.1%) patient was confirmed to have bilateral hilar lymphadenopathy. The consistency of the rash was almost firm rubbery plaque. The histopathology of the rash showed non-necrotizing granuloma and many of them were naked with little or no inflammatory reaction, pigmented particles were observed inside the granuloma. Conclusion: There has been an upsurge of cases of eyebrow tattoo sarcoidosis in the last few years. The clinical and histopathological pictures of these cases have some features of cutaneous sarcoidosis. This increased frequency of tattooing sarcoidosis goes parallel with upsurge of cases of cutaneous sarcoidosis.References
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