Case Report: Tattoo sarcoidosis with epithelioid cell granuloma positive for Propionibacterium acnes
IntroductionTattoo 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 reportA 28-year-old man presented with subcutaneous nodules at two tat...
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Frontiers Media S.A.
2025-03-01
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| author | Yuiko Masuda Hiroko Okabayashi Kimitaka Akaike Shohei Hamada Aiko Masunaga Hidenori Ichiyasu Kenichi Ohashi Takuro Sakagami |
| author_facet | Yuiko Masuda Hiroko Okabayashi Kimitaka Akaike Shohei Hamada Aiko Masunaga Hidenori Ichiyasu Kenichi Ohashi Takuro Sakagami |
| author_sort | Yuiko Masuda |
| collection | DOAJ |
| description | IntroductionTattoo 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 reportA 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.ConclusionThe 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. |
| format | Article |
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| institution | DOAJ |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj-art-d8cd737ff0c74c76b77cfaa6d2cdbab62025-08-20T03:02:37ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-03-011210.3389/fmed.2025.15521141552114Case Report: Tattoo sarcoidosis with epithelioid cell granuloma positive for Propionibacterium acnesYuiko Masuda0Hiroko Okabayashi1Kimitaka Akaike2Shohei Hamada3Aiko Masunaga4Hidenori Ichiyasu5Kenichi Ohashi6Takuro Sakagami7Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life, Sciences, Kumamoto University, Kumamoto, JapanDepartment of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life, Sciences, Kumamoto University, Kumamoto, JapanDepartment of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life, Sciences, Kumamoto University, Kumamoto, JapanDepartment of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life, Sciences, Kumamoto University, Kumamoto, JapanDepartment of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life, Sciences, Kumamoto University, Kumamoto, JapanDepartment of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life, Sciences, Kumamoto University, Kumamoto, JapanDepartment of Human Pathology, Institute of Science Tokyo, Tokyo, JapanDepartment of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life, Sciences, Kumamoto University, Kumamoto, JapanIntroductionTattoo 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 reportA 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.ConclusionThe 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.https://www.frontiersin.org/articles/10.3389/fmed.2025.1552114/fulltattoo sarcoidosissarcoidosistattooPropionibacterium acnesCutibacterium acnes |
| spellingShingle | Yuiko Masuda Hiroko Okabayashi Kimitaka Akaike Shohei Hamada Aiko Masunaga Hidenori Ichiyasu Kenichi Ohashi Takuro Sakagami Case Report: Tattoo sarcoidosis with epithelioid cell granuloma positive for Propionibacterium acnes Frontiers in Medicine tattoo sarcoidosis sarcoidosis tattoo Propionibacterium acnes Cutibacterium acnes |
| title | Case Report: Tattoo sarcoidosis with epithelioid cell granuloma positive for Propionibacterium acnes |
| title_full | Case Report: Tattoo sarcoidosis with epithelioid cell granuloma positive for Propionibacterium acnes |
| title_fullStr | Case Report: Tattoo sarcoidosis with epithelioid cell granuloma positive for Propionibacterium acnes |
| title_full_unstemmed | Case Report: Tattoo sarcoidosis with epithelioid cell granuloma positive for Propionibacterium acnes |
| title_short | Case Report: Tattoo sarcoidosis with epithelioid cell granuloma positive for Propionibacterium acnes |
| title_sort | case report tattoo sarcoidosis with epithelioid cell granuloma positive for propionibacterium acnes |
| topic | tattoo sarcoidosis sarcoidosis tattoo Propionibacterium acnes Cutibacterium acnes |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1552114/full |
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