Symptoms of ASIA Syndrome in a Female Patient with Tattoos – A Case Report

The autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA) is a relatively novel clinical entity characterized by the emergence of autoimmune-like manifestations triggered by exposure to substances with immunostimulatory potential in genetically predisposed individuals. Such substances, called adjuvants, encompass infectious and toxic agents, substances utilized in the cosmetic industry, as well as in aesthetic and regenerative medicine. In this manuscript, we present a case of a 46-year-old female patient with multiple colored tattoos and a medical history of hypothyroidism and vulvar lichen sclerosus, who developed progressive musculoskeletal, neurological and cutaneous manifestations. Our study further emphasizes the critical need for differential diagnosis between ASIA syndrome and other immune-mediated pathologies, while advocating for enhanced clinical vigilance with thorough attention to the subjective examination, comprehensive review of prior medical conditions, and detailed assessment of potential exposure to adjuvants.