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The lady with the dragon tattoo

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Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Though the skin is affected in sarcoidosis in about one-third of cases, granulomatous tattoo reactions are an unusual manifestation of the disease. It is important phenomenon to recognize, as it frequently leads to the diagnosis of systemic sarcoidosis.

Case presentation

A 35-year-old Caucasian female with multiple tattoos presented with a 5-week history of tenderness of the black dye in a tattoo depicting a dragon. She also described a 15-month history of fatigue, polyarthralgia, and mild dyspnea. Skin biopsy demonstrated multiple dermal non-caseating granulomata with associated tattoo ink. Further investigation revealed the presence of systemic sarcoidosis. Her symptoms and skin changes improved with conservative management.

Conclusion

Sarcoidal tattoo reactions in those without systemic sarcoidosis are a rare occurrence, and their presence should prompt a search for systemic involvement. The accurate identification of skin involvement in sarcoidosis is important, as it tends to occur early in the course of disease, and the skin is a readily accessible site for biopsy, allowing for prompt diagnosis.

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Authors and Affiliations

  1. Department of Medicine, St Vincent’s University Hospital and University College Dublin (UCD), Elm Park, Dublin 4, Ireland

    S. L. O’Beirne, D. N. O’Dwyer, S. M. Walsh & S. C. Donnelly

  2. Department of Radiology, St Vincent’s University Hospital and University College Dublin (UCD), Elm Park, Dublin 4, Ireland

    J. D. Dodd

  3. Department of Pathology, St Vincent’s University Hospital and University College Dublin (UCD), Elm Park, Dublin 4, Ireland

    T. B. Crotty

Authors
  1. S. L. O’Beirne
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  2. D. N. O’Dwyer
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  3. S. M. Walsh
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  4. J. D. Dodd
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  5. T. B. Crotty
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  6. S. C. Donnelly
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Corresponding author

Correspondence to S. L. O’Beirne.

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Each of the authors declare that no conflicts of interest exist.

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Written informed consent was obtained from the patient for the publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.

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O’Beirne, S.L., O’Dwyer, D.N., Walsh, S.M. et al. The lady with the dragon tattoo. Ir J Med Sci 186, 157–160 (2017). https://doi.org/10.1007/s11845-016-1439-1

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  • DOI: https://doi.org/10.1007/s11845-016-1439-1

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