A Case of Sarcoidal Foreign Body Reaction to Permanent Makeup: The Involvement of M2 Macrophages

A 50-year-old Japanese woman developed a sarcoidal foreign body reaction 9 years after receiving permanent makeup (PMU) on her eyebrows, presenting with itching, pain, swelling, and hair loss. Histological analysis revealed epithelioid granulomas and a predominance of M2 macrophages, suggesting a transition to inflammation resolution. Treatment with monthly steroid injections led to significant improvement in symptoms and hair regrowth. The study highlights the role of M2 macrophages in PMU-associated sarcoidal reactions, providing new insights into the underlying mechanisms. The patient requires ongoing monitoring for potential sarcoidosis development.