A Case of Tattoo Associated Systemic Sarcoidosis
نویسندگان
چکیده
Background: Sarcoidosis is a multisystem disorder that can affect virtually any organ. Commonly affecting young to middle-aged adults throughout the world, it can affect all races, ages and both sexes [ 1 ]. Cutaneous sarcoid lesions presenting in tattoos are being increasingly reported [ 2,3,4 ], while reports of systemic or pulmonary sarcoidosis presenting as a granulomatous tattoo reaction are rare [ 5,6,7,8 ]. This is a case of systemic sarcoidosis with pulmonary involvement presenting as tattoo associated skin lesions and elevated transaminases. Case presentation: A 37 year old African American man with past medical history significant for tattoos over 9 years and chronically elevated liver enzymes presented for evaluation of newonset itching and nodular lesions in the location of previous tattoos. The patient reported a 40lb weight loss over the past year but denied symptoms such as abdominal pain, shortness of breath, fevers, chills, cough or sputum production. The patient underwent an abdominal CT scan which noted cirrhosis, splenomegaly and numerous scattered micronodules in both lung bases. Subsequent CT of the chest demonstrated scatted pulmonary nodules predominately in the upper lobes with associated mediastinal and hilar adenopathy. Biopsies of the noted skin lesions revealed noncaseating granulomatous inflammation consistent with sarcoidosis. Conclusion: Systemic and pulmonary sarcoidosis presenting as a granulomatous tattoo reaction is rare. Complications often directly related to tattooing include immediate benign inflammatory reactions, allergic reactions to pigment, and transmission of infectious diseases related to contaminated equipment. Other localized or systemic reactions include discoid lupus, psoriasis, lichen planus and secondary lesions of syphilis [ 9 ]. Cutaneous lesions of sarcoidosis associated with tattooing are now being increasingly reported [ 2, 3,4 ] and the time of the appearance lesions has been reported from as little as 1 year to greater than 10 years [ 8,10 ]. As pulmonary involvement in sarcoidosis results in major morbidity and mortality associated with the disease [ 8 ] clinicians should be aware of this particular skin finding and the predisposition of tattoos to harbor these lesions as they may herald pulmonary sarcoidosis. Early recognition is essential for timely diagnosis and treatment of this disease.
منابع مشابه
Sarcoidosis following Tattoo: A case report
Between 20% and 35% of patients with systemic sarcoidosis have skin lesions. One of the unusual cutaneous presentations of sarcoidosis is a granulomatous tattoo reaction that may present alone or with other features of sarcoidosis. We present a case of sarcoidosis whom presented with multiple nodules on tattood skin accompanied with facial pulsy, parotid enlargement and uveitis.
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BACKGROUND Cases of tattoo sarcoidosis reported in English and French literature have recently been reviewed; however, only two Japanese patients were included in the review because most Japanese patients were reported in Japanese journals. OBJECTIVES To determine the clinical characteristics of Japanese tattoo sarcoidosis. METHODS We reported a Japanese female with tattoo sarcoidosis, and ...
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