Figure 1: Erythematous, firm nodules with foci of superficial erosion localized to red-containing pigmentary areas of a recently placed tattoo (note involvement of the cartoon’s lips, dress, and heart shape).
Editor’s Note: This month The Rheumatologist is introducing a new feature: Dermatology Case Review. See if you can diagnose the dermatological condition from the photograph and case history.
The Case
A 33-year-old woman presents with somewhat pruritic, nodular lesions worsening over the past three months in the site of a newly placed tattoo. The nodules are restricted to certain portions of the tattoo only (see Figure 1).
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What is your diagnosis?
- Majocchi’s granuloma
- Atypical mycobacterial infection
- Hypersensitivity reaction to tattoo particles
- Sarcoidosis
- Hypertrophic lichen planus