title: Granulomatous dermatitis to iron oxide after permanent pigmentation of the eyebrows.
abstract: BACKGROUND
  Tattooing with iron oxide pigment is used to create a permanent line along the eyelid margins and to cause permanent pigmentation of the eyebrows. However inflammatory sequelae can occur.
  
  
  OBJECTIVE
  To present the development and treatment of a granulomatous inflammation as a sequela of iron oxide tattooing in the eyebrows.
  
  
  METHODS
  A skin biopsy was performed, Histopathologic examination revealed deposits of reddish-brown pigment and a superficial dermal infiltrate consisting of lymphocytes and giant multinucleated cells (Langhan's and foreign body).
  
  
  RESULTS
  A patient developed a granulomatous reaction to iron oxide after undergoing permanent pigmentation of the eyebrows. Treatment with systemic and topical steroids resulted in marked improvement at 6-month follow-up.
  
  
  CONCLUSIONS
  This is an unusual complication. A skin test should be performed on any patient who is to undergo tattooing with iron oxide pigment.
authors.affiliation: Department of Dermatology, University of Puerto Rico, School of Medicine, San Juan.
authors.forename: E I
authors.initials: EI
authors.lastname: Rubianes
authors.forename: J L
authors.initials: JL
authors.lastname: Sánchez
mesh_terms: D003877:Dermatitis, Contact / Q000209:etiology* / Q000473:pathology; D005138:Eyebrows / Q000473:pathology*; D005260:Female; D005290:Ferric Compounds / Q000009:adverse effects*; D005549:Foreign-Body Reaction / Q000473:pathology; D006099:Granuloma / Q000139:chemically induced / Q000473:pathology; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D008875:Middle Aged; D013653:Tattooing / Q000009:adverse effects*
chemical_list: D005290:Ferric Compounds; C000499:ferric oxide