About 15 months after getting her eyebrows permanently tattooed, a woman was surprised to find purple spots around her eyebrows, which later spread to other areas of her body, including her elbow and upper back.
The 46-year-old woman consulted dermatologists to find out the cause.
The tests revealed surprising results: she was suffering from a rare disease called sarcoidosis, an inflammatory autoimmune disease that occurs when the immune system overreacts to a foreign substance. In this case, the trigger was the permanent tattoo ink applied to her eyebrows.
The biopsy showed inflamed granulomas, which are clusters of white blood cells that indicate the presence of this disease.
It is a disease that most often affects the lungs or lymph nodes, but in about a quarter of cases it appears on the skin. It can spread to the joints and nervous system, and in rare and severe cases, it can reach the heart.
Although the exact cause is unknown, it is often linked to an immune reaction to foreign stimuli such as tattoo ink. Genetic factors may also increase the risk of developing it.
After initial topical treatment failed to significantly improve her condition, doctors prescribed corticosteroid (prednisolone) therapy for the woman, and the result was astonishing: a marked clinical improvement within one week in all affected areas.
The woman continued to take decreasing doses weekly until the symptoms disappeared completely.
This is not the first such case. In 2011, an outbreak of sarcoidosis was recorded in Switzerland affecting 12 people who had received tattoos from the same tattoo artist. The fact is that any type of tattoo can trigger adverse immune reactions, due to the ink's components, which sometimes contain heavy metals such as nickel, chromium, cobalt, and lead—substances known to cause allergies even in small amounts.
For a tattoo to become permanent, the body needs an immune response that traps the ink particles within skin cells. When ink is injected under the skin, immune cells treat it as a foreign substance and try to remove it, but larger particles remain trapped, forming the tattoo. This process is safe for most people, but some may be more prone to adverse reactions.
What is unique about this woman’s case is that the spots have moved to parts far removed from her eyebrows, which means that the disease did not remain localized but spread throughout her body.
Therefore, doctors warn that when symptoms of sarcoidosis appear in the tattooed area, a full examination of the patient should be performed, including chest imaging and laboratory tests, to ensure that the disease has not spread internally, especially around the lungs.
Doctors emphasize that "early identification of the widespread disease is crucial to initiating appropriate treatment and preventing chronic complications."
