Delayed complication from a tattoo.

Volume 86, Number 7 www.aafp.org/afp American Family Physician 669 A 39-year-old man presented with small nodules that had developed in his tattoos over the previous eight weeks. The nodules were not painful or pruritic. They were present only in the blue portions of the tattoo, but appeared in different tattoos on his arms and upper back (Figures 1 and 2). The tattoos were professionally applied about 12 to 13 years prior at the same tattoo parlor. The patient had diabetes mellitus, hypertension, and gout, which were all well controlled. He was also a smoker. He was taking metformin (Glucophage), glipizide (Glucotrol), allopurinol (Zyloprim), lisinopril (Zestril), and meloxicam (Mobic). The nodules continued to develop over the next six weeks, after which no significant changes were noted. A biopsy was performed.