Cutaneous Sarcoidosis

Q: Which ink color is more prone to develop Tattoo sarcoidosis? - select one

A) black

B) blue

C) red

D) green

E) purple

Answer: C

It may be interesting to know that sarcoid granulomas if developed in tattoos, can present signs of sarcoidosis. All such patients should be evaluated for systemic disease. It may take decades for such manifestation to appear, but it usually happens within one year of the tattoo placement.

For unknown reasons, its the red ink (cinnabar) tattoos which are more prone to develop

sarcoidosis, though other pigments can also be responsible for that. Eyebrows and lips tend to get affected more.

On physical exam, it appears like papules within a tattoo that are usually raised, firm, and edematous. The patient reports pain and/or pruritus. Histopathology shows the presence of sarcoid granulomas with aggregates of epithelioid cells surrounded by peripheral rings of lymphocytes. Differential diagnosis includes foreign body reactions.

#dermatology

#vasculitis

References:

1. Antonovich DD, Callen JP. Development of sarcoidosis in cosmetic tattoos. Arch Dermatol 2005; 141:869.

2. Caplan A, Rosenbach M, Imadojemu S. Cutaneous Sarcoidosis. Semin Respir Crit Care Med. 2020 Oct;41(5):689-699. doi: 10.1055/s-0040-1713130. Epub 2020 Jun 27. PMID: 32593176.

3. Abdelghaffar M, Hwang E, Damsky W. Cutaneous Sarcoidosis. Clin Chest Med. 2024 Mar;45(1):71-89. doi: 10.1016/j.ccm.2023.08.004. Epub 2023 Oct 28. PMID: 38245372.