Systemic sarcoidosis presenting as a granulomatous tattoo reaction secondary to interferon-alpha treatment for chronic hepatitis C and review of the literature.
Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Immune alterations involving heightened T-helper-1 responses have been proposed to play a major role in the pathogenesis of sarcoidosis. Interferon-alpha therapy and hepatitis C infection have been implicated in the development of a variety of autoimmune diseases. However, despite the wide use of IFN-alpha therapy for hepatitis C, only a few cases of sarcoidosis have been reported in this context. We report the case of a 42-year-old white female with hepatitis C, who developed systemic sarcoidosis shortly after therapy with IFN-alpha2b. The disease was heralded by the appearance of a cutaneous sarcoid/ foreign body granulomatous reaction at the site of an old tattoo. The sarcoidosis responded to a short course of oral prednisone therapy. We also reviewed the other reported cases and discussed the possible immunological mechanisms involved.
Department of Gastroenterology, Albany Medical College, New York 12208, USA.
Ali
A
Nawras
Mohammad M
MM
Alsolaiman
Shahid
S
Mehboob
Catherine
C
Bartholomew
Benedict
B
Maliakkal
D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006099:Granuloma / Q000139:chemically induced / Q000276:immunology*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D012507:Sarcoidosis / Q000139:chemically induced / Q000276:immunology*; D012871:Skin Diseases / Q000139:chemically induced / Q000276:immunology; D013653:Tattooing
D000998:Antiviral Agents; D016898:Interferon-alpha