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(Kushima etal., BMJ Case Reports, 2020)

A Man Lost His Hearing And Suffered Inflamed Eyes After Getting a Standard Back Tattoo

26 AUGUST 2020

Getting inked isn't without its share of risks. We're not just talking regrets over your ex's name either – there's the slim chance of an allergic reaction, possibility of infection, and even the potential you'll hide warning signs of cancer.

 

Thankfully, hearing loss, lung lesions, and eye inflammation aren't usually concerns for the freshly tattooed. But when specialists at Fukuoka University Hospital in Japan encountered these symptoms in a 35-year-old male patient, they were able to link them back to his recent art piece.

Tattoos were probably the furthest thing from the patient's mind when he presented to the Department of Ophthalmology after suffering abnormal vision for the past four months.

Doctors diagnosed the man with an inflammatory condition called uveitis, which gets its name because it affects the middle layer of tissue in the eye's wall called the uvea.

Without any obvious signs of trauma or infection that could be blamed for the condition, medical specialists suspected that accumulations of inflammatory cells called granulomas might be behind the swelling and redness.

The condition itself is referred to as sarcoidosis. Although it's associated with an immune response, its trigger isn't always obvious.

Sure enough, blood tests showed elevated levels of the sorts of hormones expected in an immune response. A CT scan of the patient's chest also revealed a bunch of tiny nodules, another feature common in cases of sarcoidosis.

 

Shortly after receiving treatment, the man came down with yet another symptom – a loss of hearing in both ears.

Though not overly common, a quick look through the literature reveals cases where those granuloma parties can accumulate around nerves in the skull and around the face, interfering with hearing.

Fortunately a couple of weeks on corticosteroids did the trick, clearing up not just the eye inflammation but returning the patient's hearing.

As to the cause, while investigating his symptoms the doctors took a close look at the six-month-old tattoo on the man's back.

They found signs of granulomas in the skin eruptions within the tattoo's inked lines. It's not uncommon to find these painless lesions popping up as a reaction to the metals in certain inks, especially months following injection.

It's probably not all that surprising that tattoos can occasionally trigger reactions in hypersensitive individuals. In recent years we've learned more about how white blood cells are the caretakers of the ink, going as far as passing it down through the generations.

With the immune system playing such a central role in maintaining a tattoo, there's bound to be cases where biology goes a little astray.

 

Luckily the course of corticosteroids cleared up the patient's tattoo granulomas too, leaving him with skin as clear as his hearing.

In this case, the link between the back tattoo and sarcoidosis isn't confirmed beyond all doubt. Nonetheless, the authors advise signs of granulomas in relatively recent ink should be a reason to look for signs of inflammation elsewhere in the body.

Just one more thing to keep in mind when getting your partner's name inked into your back.

This research was published in BMJ Case Reports.