Figure 1a: Induration and pain developed 2 weeks after placement of the tattoo.
Figure 1b: Two weeks later ulceration developed and was biopsied.
The patient was a 27-year-old woman who had a tattoo on her ankle a few weeks prior to the presentation at a dermatologist’s office. Approximately 2 weeks after the tattoo was placed, induration and discoloration developed within the red part of the tattoo. The patient developed progressive induration and pain of the area (Figure 1a). One month after placement of the tattoo, the areas of induration underwent ulceration. A biopsy was performed of one of the ulcerated foci (Figure 1b).
The best diagnosis is:
a. Hematogenously disseminated atypical mycobacterium infection
b. Necrotizing sarcoidosis manifesting an isotopic reaction at a site of a tattoo
c. Wegener granulomatosis
e. Inoculation atypical mycobacterium