Residing in disadvantaged neighborhoods and tattoo-associated sarcoidosis

Introduction and objective. Cutaneous lesions developing within tattoos is a well-recognized, relatively rare manifestation of sarcoidosis. Lower socioeconomic status is associated with greater skin disease severity in sarcoidosis patients. Therefore, the objective of this retrospective, single-site study was to determine whether residing in disadvantaged neighborhoods in Chicago, Illinois may espouse tattoo-associated sarcoidosis. Methods. 20 patient charts at the University of Illinois Hospital in Chicago were found to have tattoos and biopsy-proven cutaneous sarcoidosis. The patients were categorized according to presence or absence of noncaseating granulomas consistent with sarcoidosis located within tattoo pigmentation. Patients’ Chicago zip codes were ranked by socioeconomic disadvantage using the validated University of Wisconsin-Madison Area Deprivation Index (ADI) where an affluent neighborhood had a score of ≤5 and a disadvantaged neighborhood had a score >5. Analysis utilized Welch’s t-test. P<0.05 was considered statistically significant. Results. Fourteen patients had tattoo-associated sarcoidosis whereas six did not. Patients residing in affluent neighborhoods (n=8) had significantly higher tattoo-associated sarcoidosis than those in disadvantaged neighborhoods (n=12). Patients with tattoo-associated sarcoidosis had a median ADI of 5 and an average ADI of 4.21 (CI 2.68, 5.75) whereas patients without tattoo-associated sarcoidosis had a median of 9 and average of 8.5 (CI 7.13, 9.87) (p=0.001). Other demographic comparisons were not statistically significant (p >0.05). Conclusions. Tattoo-associated sarcoidosis was correlated to patients residing in affluent neighborhoods in Chicago. However, the mechanism(s) underlying this phenomenon was not found. Prospective, multi-site randomized studies are warranted to corroborate these findings.