True blue football fan: tattoo reaction confined to blue pigment.

A tattoo reaction which appeared solely on the blue pigment of a 6-month old red and blue football club tattoo of an ardent fan was investigated. The patient was otherwise asymptomatic and no other abnormality was detected on full physical examination. Histology revealed a florid sarcoidal granuloma reaction to blue pigment. Preliminary investigations for systemic sarcoidosis did not reveal any abnormality. The tattoo reaction flattened clinically with the institution of a short course of topical mometasone furoate 0.1% ointment and as the subject remained asymptomatic, close surveillance for the development of systemic sarcoidosis is to continue. The possibility of delayed type hypersensitivity is discussed.