Post-corneal tattooing trigeminal nerve-distributed hyperpigmentation: a case report.

BACKGROUND: keratopigmentation is a proven cosmetic and surgical intervention for corneal irregularities or opaqueness, notably in blind eye. postoperative skin hyperpigmentation localized to a trigeminal nerve distribution has not been documented in any previous research. CASE PRESENTATION: We present a rare case of trigeminal nerve-distributed hyperpigmentation following corneal tattooing in a patient with a history of multiple procedures. Over the years, he underwent multiple ocular and periocular reconstructive surgeries. The patient initially underwent corneal tattooing in December 2014 for cosmetic rehabilitation, which yielded satisfactory results with no complaints. However, following an augmentation of the corneal tattoo in 2023, he developed hyperpigmentation of the skin localized to the ophthalmic (V1) division of the trigeminal nerve. CONCLUSION: This case showcases an uncommon but noteworthy dermatologic reaction following ocular tattooing, raising questions about potential pigment migration, neural-mediated skin responses, or localized inflammatory sequelae.