People are exposed daily to the intracellular microbiota that cause chronic inflammatory diseases. They exist in food, water, injectable medications, body fluids and have even been cultured from dry soil.

As with all injected substances, there is a small risk of introducing these pathogens during the process of tattooing.

Lupus vulgaris over a tattoo mark. Lupus vulgaris is caused by tuberculosis. While tuberculosis is widely accepted as an infectious disease, it is notable that chronic inflammatory diseases of “unknown” origin can also show cutaneous disease-specific lesions following a tattoo. This suggests a common, if not species-specific, pathology.

Researchers have documented that diseases such as lupus vulgaris (painful skin lesions caused by M. tuberculosis bacteria) can be induced by a tattoo procedure.1) Tuberculosis, of course, is unquestionably a bacterial illness.

But the literature also contains multiple reports of sarcoidosis patients – a disease of supposedly unknown origin – also developing skin lesions within tattoos. According to one researcher, this is “a well-recognized occurrence in patients with sarcoidosis.”2) Ali reviews dozens of cases in which granuloma have formed, more often than not, years after the application of a tattoo.3) More than one case report describes how a patient developed sarcoidal granulomas in only one pigment of a tattoo4) – which suggests that the needle corresponding to that pigment was infected.

There are a number of explanations for how a tattoo could cause this reaction, but the most logical one is that tattoo needles introduce new pathogens into the skin. For one, the fact that sarcoid granuloma appear years after the application of a tattoo corresponds nicely with the length of time it takes for bacteria to grow.

===== Notes and comments =====

===== References=====

Ghorpade A. Lupus vulgaris over a tattoo mark--inoculation tuberculosis. J Eur Acad Dermatol Venereol. 2003 Sep;17(5):569-71. doi: 10.1046/j.1468-3083.2003.00787.x.
[PMID: 12941097] [DOI: 10.1046/j.1468-3083.2003.00787.x]
Antonovich DD, Callen JP. Development of sarcoidosis in cosmetic tattoos. Arch Dermatol. 2005 Jul;141(7):869-72. doi: 10.1001/archderm.141.7.869.
[PMID: 16027303] [DOI: 10.1001/archderm.141.7.869]
3) , 4)
Ali SM, Gilliam AC, Brodell RT. Sarcoidosis appearing in a tattoo. J Cutan Med Surg. 2008 Jan-Feb;12(1):43-8. doi: 10.2310/7750.2007.00040.
[PMID: 18258148] [DOI: 10.2310/7750.2007.00040]
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