Granulomatous Dermatitis to Iron Oxide After Permanent Pigmentation of the Eyebrows

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Abstract
Background. Tattooing with iron oxide pigment is used to create a permanent line along the eyelid margins and to cause permanent pigmentation of the eyebrows. However inflammatory sequlae can occur. objective: To present the development and treatment of a granulomatous inflammation as a sequela of iron oxide tattooing in the eyebrows. method: A skin biopsy was performed, Histopathologic examination revealed deposits of reddish-brown pigment and a superficial dermal infiltrate consisting of lymphocytes and giant multinucleated cells (Langhan's and foreign body). result: A patient developed a granulomatous reaction to iron oxide after undergoing permanent pigmentation of the eyebrows. Treatment with systemic and topical steroids resulted in marked improvement at 6-month follow-up. conclusions: This is an unusual complication. A skin test should be performed on any patient who is to undergo tattooing with iron oxide pigment.

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