[Sarcoid granuloma in green tattooing]

The case report is presented of a 34-year old man with the sudden appearance of multiple granulomas at the site of green tattoo markings which had been undertaken 8 years previously. Unusual was his case history of an anaphylactic reaction after the ingestion of green pistachio nuts. A non-immunological food intolerance without cross-reaction to the dye of the green tattoo namely phthalocyanine, was detected. Aerosil, colloidal silica, was found to be the trigger substance; it was present exclusively in the green dye, and was responsible for the patient's sarcoid reaction. Excision of the green tattoos employing pedicle flaps was successful. At the latest follow-up examination no features of sarcoidosis were detected.