A Case of Iatrogenic Cutaneous Lipomatosis.

Lipomas are the most common type of soft tissue benign tumor with a prevalence of 2.1 per 1000 people (1). They generally occur in adult patients between the ages of 40 and 60 years as solitary lesions. In some cases, however, there can be multiple lipomas involving several members of a family or associated with other systemic manifestations as in some syndromes. Cases of iatrogenic lipomatosis have been reported only rarely (2,3). We report the case of a man that developed multiple lipomas after making a tattoo. A 45-year-old man presented with multiple, subcutaneous, soft, and mobile skin lesions on the left upper limbs, which had appeared about 2 years earlier (Figure 1). They were of various dimensions, were not painful, and had not recently increased in size. Physical examination found a BMI of 25.9. An ultrasound examination of cutaneous lesions showed multiple oval hyperechoic neoformations with smooth margins between 15 and 35 mm in size. Histological examination of one of the nodules showed mature adipocyte depositions in the subcutaneous tissue (Figure 2). The patient said that these lesions appeared after making a tattoo on his arm. The tattoo was administered in a professional studio 2.5 years ago. The familial history was negative for multiple lipomas. He had no significant past medical history. He was a non-smoker and consumed only a moderate amount of alcohol. Complete blood count, liver and kidney function tests, serum protein level, plasma glucose level, triglycerides, and cholesterol were all normal. We excluded pharmaceutical causes such as corticosteroid treatment, prior chemotherapies, and use of other drugs. On the basis of the clinicopathologic findings, the diagnosis of lipomatosis was made. Lipomas can be either isolated entities or involved in multiple lipomatosis, which are most often associated with specific congenital, familial, or idiopathic syndromes such Madelung’s syndrome (characterized by an accumulation of adipose tissue significantly and symmetrically in the neck, head, and upper trunk which affects mainly males with a history of alcohol abuse) (4), Cowden syndrome (characterized by multiple lipomas and an increased risk of malignancies of the breast, thyroid, endometrium, kidney, and colorectum) (5), Dercum’s disease (characterized by painful multiple lipomas which affect mainly women, especially postmenopausally) (6), and familial lipomatosis (characterized by regional excess of subcutaneous adipose tissue in members of the same family) (7).