Tattoo-associated uveitis

Trucian A. Ostheimer, Bryn M. Burkholder, Theresa G. Leung, Nicholas J. Butler, James P. Dunn, Jennifer E. Thorne

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose To describe the clinical presentation of uveitis with coincident onset of raised and indurated tattooed skin. Design Case series. Methods Seven consecutive patients were evaluated at a tertiary ophthalmologic facility with coincident uveitis and cutaneous tattoo induration over an 18-month period. All subjects underwent complete ophthalmic examination and a focused systemic medical evaluation including serologic testing and imaging studies. Two participants underwent biopsy of their tattoos. The patients' clinical courses and responses to treatment over a follow-up period of 1-20 months are reported (mean follow-up = 9 months). Main outcome measures included degree of intraocular inflammation, ocular complications, visual acuity, clinically observable tattooed skin changes, and biopsy results. Results Five of 7 patients had bilateral nongranulomatous anterior uveitis: 4 with chronic and 1 with recurrent disease. The remaining 2 patients had bilateral chronic granulomatous panuveitis. Biopsies of raised and indurated tattoos were performed in 2 patients and demonstrated noncaseating granulomatous inflammation surrounding tattoo ink in the dermis. The skin changes resolved in all patients, with a faster response noted in those treated with high-dose oral prednisone for intraocular inflammation. Five patients subsequently experienced recurrent flares of intraocular inflammation in conjunction with the recurrence of raised and indurated tattoos. Conclusions These cases represent a subset of patients in whom skin tattooing may have incited an immune response leading to simultaneous inflammation of the eyes and tattooed skin.

Original languageEnglish (US)
Pages (from-to)637-643.e1
JournalAmerican journal of ophthalmology
Volume158
Issue number3
DOIs
StatePublished - Sep 2014

ASJC Scopus subject areas

  • Ophthalmology

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