Permanent Makeup Procedure Heralds the Development of Systemic Sarcoidosis

Area of Science:

• Dermatology
• Immunology
• Systemic Inflammatory Diseases

Background:

• Permanent cosmetic procedures, including tattooing, are recognized risk factors for cutaneous granulomatous conditions.
• Scar sarcoidosis is an infrequent manifestation of systemic granulomatous disease, with limited reported cases globally.
• Granuloma formation at tattoo sites, though rare, can precipitate severe systemic inflammatory responses.

Observation:

• A 48-year-old Hispanic female presented with new-onset scar sarcoidosis originating from cosmetic eyebrow tattooing.
• Erythematous maculopapular eruptions appeared at the tattoo sites, preceding an exacerbation of her small airway disease.

Findings:

• Histopathologic examination confirmed cutaneous sarcoidosis, characterized by non-caseating epithelioid granulomas.
• The case demonstrates granuloma formation at pigment deposition sites, potentially leading to systemic inflammation.

Implications:

• This case underscores the significance of early detection of cutaneous sarcoidosis in established scars.
• Identifying scar sarcoidosis is vital due to its association with the risk of developing systemic sarcoidosis.