Microblading-Induced Granulomatous Reaction: Case Report and Review of the Literature

Abstract

Microblading is a common cosmetic procedure that can modify the appearance of one's eyebrows. Although generally well-tolerated, the procedure can cause a number of dermatologic issues; on rare occasions, granulomatous reactions can manifest. We use this case to highlight a presentation of a nonsarcoidal granulomatous dermatitis and review the literature on granulomatous reactions secondary to microblading. Of the 21 cases included in our review, approximately half (10/21) were diagnosed with foreign-body granulomas and the other half with sarcoidosis (7 of 21 with systemic sarcoidosis and 4 of 21 with cutaneous sarcoidosis). Although microblading remains a commonplace cosmetic technique, it is not without risk. Much like other types of tattoos, microblading can cause granulomatous reactions for which we must be vigilant, and further workup for sarcoidosis might be considered in select patients.

A rapid review of physical health risks associated with special procedures (tattooing, body piercing, acupuncture, electrolysis)

“…Across the 37 cases presented in 31 case reports, the clinical presentations commonly reported after following the application of semi-permanent make-up are reported in Table 1 and include erythema or redness (Akoh et al 2021, Bashinskaya et al 2022, Gilhooley et al 2020, Goldberg et al 2018, Maier et al 2015, Mirzaei et al 2017, Naeini et al 2017, Sano et al 2021, Suleman et al 2023, Tittelbach et al 2018, Vera et al 2018); oedema or swelling (Akoh et al 2021, Gilhooley et al 2020, Lahouel et al 2022, Sano et al 2021, Soltany et al 2023), pain (Motoki et al 2020) and pruritus (Abtahi-Naeini et al 2019, Ibraheim et al 2023, Lahouel et al 2022, Motoki et al 2020, Tittelbach et al 2018, Valbuena et al 2017, Vera et al 2018).…”

“…The non-microbiological adverse reactions that have been described in the context of semi-permanent make-up included 25 cases (across 19 case reports) of sarcoidosis-related reactions (Bashinskaya et al 2022, Bombonato et al 2015, Ebrahimiadib et al 2021, Gilhooley et al 2020, Hirai et al 2022, Huisman et al 2019, Ibraheim et al 2023, Iwayama et al 2017, Mirzaei et al 2017, Naeini et al 2017, Nie et al 2022, Tukenmez Demirci et al 2016, Valbuena et al 2017, Vera et al 2018, Tittelbach et al 2018); 17 cases of granulomatous reactions, including papules (Bashinskaya et al 2022, Ebrahimiadib et al 2021, Hinojosa et al 2017, Hirai et al 2022, Huisman et al 2019, Ibraheim et al 2023, Iwayama et al 2017, Leight-Dunn et al 2022, Maier et al 2015, Naeini et al 2017, Nie et al 2022, Suleman et al 2023, Sun & Lao 2023, Tittelbach et al 2018, Tukenmez Demirci et al 2016, Valbuena et al 2017); three cases of allergic reactions (Lahouel et al 2022, Ibraheim et al 2023, Motoki et al 2020), 19 cases of skin-related adverse reactions (Abtahi-Naeini et al 2019, Akoh et al 2021, Bashinskaya et al 2022, Ebrahimiadib et al 2021, Gilhooley et al 2020, Hinojosa et al 2017, Goldberg et al 2018, Hirai et al 2022, Maier et al 2015, Mirzaei et al 2017, Naeini et al 2017, Marcelino et al 2021, Navarro-Triviño et al 2021, Nie et al 2022, Sano et al 2021, Suleman et al 2023, Tierney & Kavanagh 2021, Tittelbach et al 2018, Vera et al 2018) and five cases of eye-related adverse reactions and other adverse reactions (Sano et al 2021, Goldberg et al 2018, Hinojosa et al 2017, Soltany et al 2023, Navarro-Triviño et al 2021).…”

“…Sarcoidosis is a multisystem inflammatory disorder characterised by the presence of granulomas in various organs and tissues throughout the body. Five cases describe cutaneous sarcoidosis (Bashinskaya et al 2022, Hinojosa et al 2017, Ibraheim et al 2023, Naeini et al 2017, Tukenmez Demirci et al 2016), five cases describe systemic sarcoidosis, i.e. affecting multiple organs systems in the body (Bashinskaya et al 2022, Ebrahimiadib et al 2021, Hinojosa et al 2017, Vera et al 2018, Huisman et al 2019), one case of pulmonary sarcoidosis (Naeini et al 2017) and one case of Löfgren’s syndrome , an acute form of sarcoidosis (Mirzaei et al 2017).…”

“…Seventeen case reports received a rating of seven out of eight (Abtahi-Naeini et al 2019, Ebrahimiadib et al 2021, Hirai et al 2022, Huisman et al 2019, Ibraheim et al 2023, Iwayama et al 2017, Lahouel et al 2022, Maier et al 2015, Marcelino et al 2021, Motoki et al 2020, Naeini et al 2017, Navarro-Triviño et al 2021, Nie et al 2022).…”