Sarcoidal Reaction of the Eyebrows after Micropigmentation: A Review of Therapeutic Approaches

Sarcoidosis is a granulomatous disease that can affect multiple organs, with cutaneous manifestations occurring in about 25% of patients. Tattooing, including the newer technique of eyebrow micropigmentation, is known to trigger sarcoidosis in genetically predisposed individuals. This study reviews the case of a 55-year-old female who developed sarcoidal reaction (SR) on her eyebrows 3 years after undergoing micropigmentation. The patient presented with erythematous, scaly plaques and partial madarosis. A biopsy-confirmed cutaneous SR and systemic disease was ruled out. Treatment involved intralesional corticosteroids followed by systemic therapy with hydroxychloroquine and oral prednisone, leading to clinical improvement. The case highlights the potential for micropigmentation to induce SR, emphasizing the importance of early diagnosis and a multidisciplinary approach. Dermatologists should be vigilant in recognizing cutaneous SR in patients with new-onset skin lesions after micropigmentation and consider both local and systemic treatments based on disease severity. This case also underscores the psychosocial impact of facial involvement, emphasizing the need for comprehensive care.