BMJ Case Reports 2018; doi:10.1136/bcr-2018-224968
  • Unusual association of diseases/symptoms

Unusual complication of a tattoo in an immunosuppressed patient

  1. William J Leach
  1. Trauma and Orthopaedics, NHS Greater Glasgow and Clyde, Glasgow, UK
  1. Correspondence to Mr William Thomas Wilson, william.wilson{at}
  • Accepted 23 May 2018
  • Published 18 June 2018


Tattooing for decorative body art is becoming more popular and, as a result, so are tattoo-related complications. Patients are unlikely to discuss tattoos with medical professionals, even though these might be relevant. Long-term immunosuppressed patients are often young adults who may wish to consider tattooing. It is well recognised that immunosuppressed patients are at increased risk of infection including cutaneous mycobacterial infections. They therefore represent a group that is at a potentially higher risk of tattoo-related complications and warrant special consideration.

We present the first documented case of inflammatory myopathy as a complication following tattooing in an immunosuppressed individual. This unusual case presented as distal thigh and medial knee pain and it was only after some time that a link to the tattoo was made. This serves as a reminder to consider tattoo-related complications in the differential diagnosis of unusual atraumatic musculoskeletal pain, especially in immunosuppressed individuals.


  • Contributors WTW was involved in the data collection and writing of the case report. MO was involved in the literature review and writing of case report. WJL was supervising consultant who was involved in design and planning of case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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