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Pruritic Papules Limited to Tattooed Skin—Diagnosis
Arch Dermatol. 2009;145(3):321-326.
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Diagnosis: Systemic and cutaneous sarcoidosis presenting in tattoos and associated with interferon and ribavirin therapy for hepatitis C.
MICROSCOPIC, RADIOLOGIC, AND LABORATORY FINDINGS
Examination of the hematoxylin-eosin–stained skin biopsy specimens from both papules and plaques within tattooed skin revealed pigment globules in the dermis in close proximity with, but not exclusively bordered by, naked noncaseating granulomas. The granulomas had a minimally dense, patchy, lymphocytic infiltrate. The aggregates of black pigment were present free within the dermis and within epithelioid histiocytes along with occasional multinucleate giant cells, consistent with sarcoidal granulomas. In addition, this patient had bilateral hilar adenopathy visualized on chest radiographs, with normal serum calcium and angiotensin converting enzyme levels. Based on these findings, the patient was given the diagnosis of sarcoidosis and treated with topical steroids. He had no further signs of systemic or cutaneous sarcoidosis after 4 months.
DISCUSSION
Sarcoidosis is a granulomatous disease capable of affecting multiple organs with a predilection for the respiratory tract, lymph nodes, and skin. Cutaneous manifestations may include reddish papules, nodules, and plaques. Cutaneous sarcoidosis . . . [Full Text of this Article]
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Arch Dermatol. 2009;145(3):321-326.
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