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Sarcoid Uveitis: A Look Beyond The Eyes.
Daniel Lemor1, David B Lazar2, W Brooks Emory3
1Department of Ophthalmology, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
Ochsner Journal
|December 22, 2016
Summary
A skin biopsy of red tattoo ink definitively diagnosed sarcoid uveitis in a patient presenting with bilateral acute uveitis. This highlights the importance of tattoo assessment in uveitis workups.
Area of Science:
- Ophthalmology
- Dermatology
- Immunology
Background:
- Bilateral acute uveitis presents a diagnostic challenge, often necessitating a comprehensive workup.
- Sarcoid uveitis is an intraocular manifestation of systemic sarcoidosis, an inflammatory disease.
Observation:
- A 40-year-old male presented with bilateral acute uveitis, characterized by photophobia, elevated intraocular pressure, and granulomatous keratic precipitates.
- Physical examination revealed induration and elevation in tattooed areas, specifically those with red pigment.
Findings:
- Serum angiotensin-converting enzyme levels were elevated, and CT imaging showed mediastinal and hilar lymphadenopathy, indicative of sarcoidosis.
- Punch biopsy of the tattooed skin revealed noncaseating granulomas, confirming sarcoidosis.
Implications:
- This case underscores the diagnostic utility of skin biopsy in identifying sarcoid uveitis.
- A thorough patient history, including inquiry about tattoos, and a complete physical examination are crucial components in the workup of uveitis.
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