Association of tattoos with cutaneous sarcoidosis and anterior uveitis

Tattoo-associated cutaneous sarcoidosis with uveitis is a rare but potentially serious cause of intraocular inflammation that requires prolonged immunosuppressive therapy to avoid vision-threatening complications. Studies have shown that a larger proportion of patients with tattoo-associated sarcoidosis exhibit elevated ACE levels compared with those with general sarcoidosis. This is likely due to a combination of exaggerated inflammatory responses and granuloma formation at tattoo sites from a chronic foreign body reaction or immune activation. We present a case of tattoo-associated cutaneous sarcoidosis with uveitis in which the patient had an elevated ACE level and was successfully treated with prednisone eye drops and weekly subcutaneous adalimumab.