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In Reply Mr Han raises questions about the differential diagnosis of cutaneous manifestations of sarcoidosis in tattoos. We included drug eruptions, T-cell lymphoma, and tuberculosis as differential diagnoses for our patient with tattoo sarcoidosis. One of the most common differential diagnoses is foreign body granuloma. These reactions are attributable to the pigment in tattoo ink. Histologically they can be differentiated by the presence of foreign bodies. Generally, reactions to single pigments are found in foreign body granulomas; if multiple pigments are involved, systemic sarcoidosis is more likely.1
Jamindar P, Powner J, Ayoola R. Etiologies of Tattoo Lesions—Reply. JAMA. 2015;314(8):836-837. doi:10.1001/jama.2015.8989