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41475 Taking the Thorns out of the Rose: Dupilumab for the Treatment of Refractory Granulomatous Tattoo Reactions - A Novel Therapeutic Indication

2023; Elsevier BV; Volume: 89; Issue: 3 Linguagem: Inglês

10.1016/j.jaad.2023.07.915

1097-6787

Charles Dunn, Yasser Faraj, Nicole Vesely, Samuel Stahly, Alan Wong, Jason Kieffer, Michael Foss, Austin Ambur, Rajiv Nathoo, Stephen Eubanks,

Tattoo and Body Piercing Complications

Background: Granulomatous hypersensitivity reactions to tattoo ink, particularly red tattoo ink, represent a common therapeutic challenge encountered in dermatologic practice. Effective treatment modalities, especially for cases refractory to anti-inflammatory medications, are limited. Much of the recommendations for these instances are based on case reports and small case series. For many of these patients, treatments are rarely curative and therapeutic responses are often incomplete. We present the case of a patient with a delayed superficial-and-deep granulomatous reaction to the red pigment of a rose-shaped tattoo that occurred approximately 8-months after the tattoo was placed (clinical/histopathologic images available). Infectious screenings were negative. Symptoms were refractory to topical, intralesional, and oral corticosteroids as well as doxycycline, allopurinol, hydroxychloroquine, Q-switched 532nm Nd:YAG laser, and a single fractional-CO2 ablative treatment.