{"title":"Case Report: Tattoo sarcoidosis with epithelioid cell granuloma positive for <i>Propionibacterium acne</i>s.","authors":"Yuiko Masuda, Hiroko Okabayashi, Kimitaka Akaike, Shohei Hamada, Aiko Masunaga, Hidenori Ichiyasu, Kenichi Ohashi, Takuro Sakagami","doi":"10.3389/fmed.2025.1552114","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Tattoo sarcoidosis is characterized by a granulomatous reaction localized to the tattoo site and typical systemic symptoms of sarcoidosis. Herein, we report the case of a patient diagnosed with tattoo sarcoidosis.</p><p><strong>Case report: </strong>A 28-year-old man presented with subcutaneous nodules at two tattoo sites, bilateral hilar and mediastinal lymphadenopathy, multiple micronodules predominantly in the upper lobes of both lungs, elevated serum angiotensin-converting enzyme and soluble interleukin-2 receptor levels, hypercalcemia, and renal dysfunction. Skin biopsy of a subcutaneous nodule revealed epithelioid cell granulomas. Although periodic acid-Schiff, Grocott methenamine silver, and acid-fast staining showed negative results, antibody staining for <i>Propionibacterium acnes</i> within the epithelioid cell granuloma was positive. Remarkably, all lesions spontaneously resolved, and the systemic manifestations also improved without medical treatment.</p><p><strong>Conclusion: </strong>The pathogenesis of tattoo sarcoidosis remains unknown, although an immune response to tattoo pigments has been suspected. However, there is a theory that <i>P. acnes</i> is the causative agent of sarcoidosis. In the present case, the detection of <i>P. acnes</i> within the epithelioid cell granuloma suggests that the bacterium may play a role in the etiology of tattoo sarcoidosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1552114"},"PeriodicalIF":3.1000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962038/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fmed.2025.1552114","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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Abstract
Introduction: Tattoo sarcoidosis is characterized by a granulomatous reaction localized to the tattoo site and typical systemic symptoms of sarcoidosis. Herein, we report the case of a patient diagnosed with tattoo sarcoidosis.
Case report: A 28-year-old man presented with subcutaneous nodules at two tattoo sites, bilateral hilar and mediastinal lymphadenopathy, multiple micronodules predominantly in the upper lobes of both lungs, elevated serum angiotensin-converting enzyme and soluble interleukin-2 receptor levels, hypercalcemia, and renal dysfunction. Skin biopsy of a subcutaneous nodule revealed epithelioid cell granulomas. Although periodic acid-Schiff, Grocott methenamine silver, and acid-fast staining showed negative results, antibody staining for Propionibacterium acnes within the epithelioid cell granuloma was positive. Remarkably, all lesions spontaneously resolved, and the systemic manifestations also improved without medical treatment.
Conclusion: The pathogenesis of tattoo sarcoidosis remains unknown, although an immune response to tattoo pigments has been suspected. However, there is a theory that P. acnes is the causative agent of sarcoidosis. In the present case, the detection of P. acnes within the epithelioid cell granuloma suggests that the bacterium may play a role in the etiology of tattoo sarcoidosis.
期刊介绍：
Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate
- the use of patient-reported outcomes under real world conditions
- the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines
- the scientific bases for guidelines and decisions from regulatory authorities
- access to medicinal products and medical devices worldwide
- addressing the grand health challenges around the world
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