{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:58:37Z","timestamp":1753891117083,"version":"3.41.2"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Tattoo 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p>A 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 <jats:italic>Propionibacterium acnes<\/jats:italic> within the epithelioid cell granuloma was positive. Remarkably, all lesions spontaneously resolved, and the systemic manifestations also improved without medical treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The pathogenesis of tattoo sarcoidosis remains unknown, although an immune response to tattoo pigments has been suspected. However, there is a theory that <jats:italic>P. acnes<\/jats:italic> is the causative agent of sarcoidosis. In the present case, the detection of <jats:italic>P. acnes<\/jats:italic> within the epithelioid cell granuloma suggests that the bacterium may play a role in the etiology of tattoo sarcoidosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1552114","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T07:08:16Z","timestamp":1742368096000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Tattoo sarcoidosis with epithelioid cell granuloma positive for Propionibacterium acnes"],"prefix":"10.3389","volume":"12","author":[{"given":"Yuiko","family":"Masuda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroko","family":"Okabayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimitaka","family":"Akaike","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shohei","family":"Hamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aiko","family":"Masunaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidenori","family":"Ichiyasu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichi","family":"Ohashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuro","family":"Sakagami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/s41572-019-0096-x","article-title":"Sarcoidosis","volume":"5","author":"Grunewald","year":"2019","journal-title":"Nat Rev Dis Primers."},{"key":"B2","doi-asserted-by":"publisher","first-page":"935289","DOI":"10.1155\/2013\/935289","article-title":"Etiologic aspect of sarcoidosis as an allergic endogenous infection caused by Propionibacterium acnes","volume":"2013","author":"Eishi","year":"2013"},{"key":"B3","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1111\/j.1365-2230.1985.tb00609.x","article-title":"Systemic sarcoidal reaction in tattoo","volume":"10","author":"Hanada","year":"1985","journal-title":"Clin Exp Dermatol."},{"key":"B4","first-page":"83","article-title":"Sarcoidal granuloma presenting on tattoo: a report of a Japanese female patient and a review of Japanese published work","volume":"33","author":"Ohtsuka","year":"2016","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis."},{"key":"B5","first-page":"86","article-title":"Sarcoidosis on tattoos: a review of the literature from 1939 to 2011","volume":"30","author":"Kluger","year":"2013","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis."},{"key":"B6","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1001\/archderm.1966.01600270070014","article-title":"Sarcoidosis. Report of a case of sarcoid lesions in a tattoo and subsequent discovery of pulmonary sarcoidosis","volume":"94","author":"Weidman","year":"1966","journal-title":"Arch Dermatol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1111\/j.1365-2230.1976.tb01448.x","article-title":"Sarcoidosis presenting in tattoos","volume":"1","author":"Kennedy","year":"1976","journal-title":"Clin Exp Dermatol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1016\/S0140-6736(05)66620-2","article-title":"Sarcoidosis in a gecko","volume":"365","author":"McGavin","year":"2005","journal-title":"Lancet."},{"key":"B9","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/S0151-9638(04)93541-7","article-title":"Sarcoidosis granuloma on a tattoo induced by interferon alpha","volume":"131","author":"Toulemonde","year":"2004","journal-title":"Ann Dermatol Venereol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1111\/j.1610-0387.2010.07391.x","article-title":"Sarcoidal granulomas in a cosmetic tattoo in association with pulmonary sarcoidosis","volume":"8","author":"Baumgartner","year":"2010","journal-title":"J Dtsch Dermatol Ges."},{"key":"B11","first-page":"63","article-title":"male case with granulomatous lung disease associated with a whole body tattoo","volume":"28","author":"Ikeda","year":"2008","journal-title":"Jpn J Sarcoidosis Granulomatous Disord."},{"key":"B12","doi-asserted-by":"publisher","first-page":"12","DOI":"10.7878\/jjsogd.42.1_2_12","article-title":"Viewpoints of infiltrative scar and scar sarcoidosis in and outside Japan: proposal of a new classification of cutaneous manifestation of systemic sarcoidosis","volume":"42","author":"Yamamoto","year":"2022","journal-title":"JJSOGD."},{"key":"B13","first-page":"e2024046","article-title":"Scar sarcoidosis: clinical features and prognostic significance","volume":"41","author":"Marcoval","year":"2024","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis."},{"key":"B14","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1002\/path.1243","volume":"198","author":"Yamada","year":"2002","journal-title":"J Pathol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1038\/modpathol.2012.80","article-title":"Localization of Propionibacterium acnes in granulomas supports a possible etiologic link between sarcoidosis and the bacterium","volume":"25","author":"Negi","year":"2012","journal-title":"Mod Pathol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1552114\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T07:08:18Z","timestamp":1742368098000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1552114\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,19]]},"references-count":15,"alternative-id":["10.3389\/fmed.2025.1552114"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1552114","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2025,3,19]]},"article-number":"1552114"}}