Clinically Amyopathic Dermatomyositis Caused by a Tattoo

INTRODUCTION: Clinically amyopathic dermatomyositis (CADM) is a rare disease with unknown origin. It is characterized by the specific skin lesions of dermatomyositis (DM) without clinical or laboratory evidence of myopathy. Previous studies indicated that tattoo may induce immune response. CASE REPORT: A 22-year-old male who tattooed butterfly on the left chest with blue and red ink. Then, he gradually had typical Gottron rash and interstitial lung disease (ILD) without weakness of the muscle. The clinical presentation and laboratory test represent the diagnosis of CADM. According to the history, CADM was induced by the tattoo five months before admission. DISCUSSION: We first reported the CADM induced by a tattoo. However, further studies are still needed to approach the specific substances within the tattoo that trigger immune response.