Cutaneous Sarcoidosis Following Microblading of the Eyebrows

Figure

a: Findings on initial presentation, b: Findings 7 months following initial presentation

A 60-year-old female patient presented with a 10-month history of scaly, infiltrated plaques on the eyebrows (Figure a). The patient had undergone microblading of the eyebrows several times, the most recent time being 2 years previously. Microblading involves the use of fine needles to implant dark pigment into the skin in order to achieve the impression of hair. The biopsy showed epithelioid foreign body granulomas. Patch testing yielded no evidence of a contact allergy to color pigments. Chest X-ray revealed bilateral hilar lymphadenopathy. Interleukin-2 receptor and serum angiotensin-converting enzyme levels were elevated. Clinically, results of pulmonary function testing and CT findings pointed to lung involvement, resulting in the initiation of a course of prednisolone (0.5 mg/kg body weight). This produced a complete resolution of the skin lesions within 4 weeks (Figure b). Further organ manifestations were ruled out. Individual case reports have described similar disease courses following tattooing and microblading, with systemic involvement seen in 50% of these. It may be that the tattoo ink acts as an immunological trigger to the development of (cutaneous) sarcoidosis.

Acknowledgment: We wish to thank the photography department at Hautklinik Uniklinikum Erlangen for providing the images..

Dr. med. Moritz Ronicke, Dr. med. Petra Wörl, Hautklinik Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, [e-mail]

Prof. Dr. med. Franklin Kiesewetter, Ärztliches Praxiszentrum am Bruderwald, Bamberg

Conflict of interest statement: The authors state that no conflict of interest exists.

Translated from the original German by Christine Rye.

Cite this as: Ronicke M, Kiesewetter F, Wörl P: Cutaneous sarcoidosis following microblading of the eyebrows. Dtsch Arztebl Int 2024; 121: 824b. DOI: 10.3238/arztebl.m2024.0170