Sarcoid granuloma on black tattoo.

We report the case of a patient with a black and turquoise tattoo who developed sarcoid granulomas on the areas of black pigment. Patch tests showed a positive reaction to nickel, cobalt, and cadmium; spectrophotometric analysis of the black pigment revealed the presence of nickel and cobalt among other metals. Although the pathogenesis of sarcoid granulomas is unknown, it seems that a delayed type hypersensitivity reaction is one of the mechanisms involved.