Editor-We read with interest Patel and Ladak's report 1 of a patient presenting with tattoo koebnerization and severe pulmonary hypertension (PH) in the setting of a new diagnosis of sarcoidosis. As the authors note, sarcoidosis-associated pulmonary hypertension (SAPH) is classified as World Health Organization group 5 PH, a "miscellaneous" form of PH that develops through various mechanistic pathways. 2 The case patient was treated with vasodilators as an inpatient, improved, and then was discharged on a regimen that included ambrisentan and tadalafil for the treatment of SAPH.