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This is likely due to a combination of exaggerated inflammatory responses and granuloma formation at tattoo sites from a chronic foreign body reaction or immune activation. We present a case of tattoo-associated cutaneous sarcoidosis with uveitis in which the patient had an elevated ACE level and was successfully treated with prednisone eye drops and weekly subcutaneous adalimumab.<\/jats:p>","DOI":"10.1136\/bcr-2025-265910","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T09:26:24Z","timestamp":1747387584000},"page":"e265910","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Association of tattoos with cutaneous sarcoidosis and anterior uveitis"],"prefix":"10.1136","volume":"18","author":[{"given":"Indira","family":"Acharya","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carey","family":"Field","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of pathology, Veterans affairs medical center, White River Junction, Vermont, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"2025082710294130000_18.5.e265910.1","article-title":"Tattoo-Associated Sarcoidosis With Severe Uveitis Successfully Treated With Mycophenolate Mofetil: A Report of Two Cases","volume":"13","author":"Nso","year":"2021","journal-title":"Cureus"},{"key":"2025082710294130000_18.5.e265910.2","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1111\/jdv.15070","article-title":"Tattoo\u2010associated uveitis with or without systemic sarcoidosis: a comparative review of the literature","volume":"32","author":"Kluger","year":"2018","journal-title":"Acad Dermatol Venereol"},{"key":"2025082710294130000_18.5.e265910.3","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1159\/000453315","article-title":"Papulo-Nodular Reactions in Black Tattoos as Markers of Sarcoidosis: Study of 92 Tattoo Reactions from a Hospital Material","volume":"232","author":"Sepehri","year":"2016","journal-title":"Dermatology (Basel)"},{"key":"2025082710294130000_18.5.e265910.4","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.ajo.2014.05.019","article-title":"Tattoo-associated uveitis","volume":"158","author":"Ostheimer","year":"2014","journal-title":"Am J Ophthalmol"},{"key":"2025082710294130000_18.5.e265910.5","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1097\/OPX.0000000000001859","article-title":"Case Series: Tattoo-associated Uveitis","volume":"99","author":"Peterson","year":"2022","journal-title":"Optom Vis Sci"},{"key":"2025082710294130000_18.5.e265910.6","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s10534-023-00564-z","article-title":"Tattoo inks: evaluation of cellular responses and analysis of some trace metals","volume":"37","author":"Sozer Karadagli","year":"2024","journal-title":"Biometals"},{"key":"2025082710294130000_18.5.e265910.7","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-025-86813-2","article-title":"Tattooed human in vitro skin model for testing the biocompatibility of tattoo inks and healing progression after tattooing","volume":"15","author":"Reddersen","year":"2025","journal-title":"Sci Rep"},{"key":"2025082710294130000_18.5.e265910.8","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1111\/cod.14105","article-title":"Quantification of preservatives in tattoo and permanent make\u2010up inks in the frame of the new requirements under the REACH Regulation","volume":"87","author":"Famele","year":"2022","journal-title":"Contact Derm"},{"key":"2025082710294130000_18.5.e265910.9","doi-asserted-by":"crossref","DOI":"10.1111\/aji.13389","article-title":"The impact of autoimmune systemic inflammation and associated medications on male reproductive health in patients with chronic rheumatological, dermatological, and gastroenterological diseases: A systematic review","volume":"85","author":"Finelli","year":"2021","journal-title":"Am J Reprod Immunol"},{"key":"2025082710294130000_18.5.e265910.10","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1093\/humupd\/dmaa022","article-title":"The effect of paternal exposure to immunosuppressive drugs on sexual function, reproductive hormones, fertility, pregnancy and offspring outcomes: a systematic review","volume":"26","author":"Perez-Garcia","year":"2020","journal-title":"Hum Reprod Update"},{"key":"2025082710294130000_18.5.e265910.11","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14151"},{"key":"2025082710294130000_18.5.e265910.12","doi-asserted-by":"crossref","unstructured":"Nangia AK , Drobnis EZ . 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