Mycobacterium Kansasii Infection Overlying Tattoo Pigment in an Immunocompromised Patient

The incidence of atypical mycobacterial infections has steadily grown over the past decades, and it is well-known that the risk of progressive disease increases with immunodeficiency. While rare, tattoo pigment can serve as a nidus for atypical mycobacterium infection in immunocompromised individuals. Here, we present a case of a 41-year-old immunocompromised female who presented with verrucous plaques overlying long-standing tattoos in multiple locations. The patient’s lesions were biopsied and sent for board-range polymerase chain reaction revealing infection with Mycobacterium kansasii, a slow-growing atypical mycobacterium that rarely causes cutaneous disease without systemic symptoms. Early recognition and treatment of cutaneous M. kansasii is important to prevent progression of disease.