Efficient pair, hydroxychloroquine monotherapy for tattoo-associated sarcoidosis

Sarcoidosis is a systemic granulomatous disease which may affect the skin in about one-third of patients. It is characterised by the histopathological finding of non-caseating granulomas. There is a predilection for cutaneous sarcoidosis towards prior trauma sites. Tattoo-associated sarcoidosis may be caused by the injected foreign pigment or its by-products. These reactions are commonly observed with black and red dyes, although other colours have been implicated. Currently, there are no evidence-based treatment regimens of tattoo sarcoidosis; however, the most commonly used treatments leading to clinical improvement in both symptoms and tattoo appearance include systemic steroids followed by immunosuppressive agents like methotrexate. We present a case of a woman with a history of pulmonary and cutaneous sarcoidosis found to have sarcoidosis within her tattoo who was successfully treated with hydroxychloroquine monotherapy, without preceding systemic corticosteroids.