RT Journal Article SR Electronic T1 Unusual complication of a tattoo in an immunosuppressed patient JF BMJ Case Reports FD BMJ Publishing Group Ltd SP bcr-2018-224968 DO 10.1136/bcr-2018-224968 VO 2018 A1 William Thomas Wilson A1 Mannix O’Boyle A1 William J Leach YR 2018 UL http://casereports.bmj.com/content/2018/bcr-2018-224968.abstract AB 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.