Do you consider skin involvement associated with tattoos to be a marker of disease activity and an indication to start treatment in a patient with sarcoidosis?  

Some patients give a clear history of swelling/pain/itch of tattoos coincident with extra-cutaneous symptoms. Others report no relationship. The variability may be related to the age, number, and size of the tattoos and the pigments they contain. Tattoos that cause symptoms should certainly be treat...