Your first patient of the day is complaining of pain in the area of his new tattoo. Upon examination, the area around the tattoo is firm, red, and swollen. There is no evidence of pus, and the patient has a normal pulse and no fever. You inform your patient that this type of response to a tattoo is called a granulomatous reaction and provide more information about the condition.

Your patient questions why he has developed a granuloma. You explain that granulomas:

A) Are formed to recruit macrophages and neutrophils to an area of persistent inflammation, such as that observed with a tattoo.

B) Result from activation of complement proteins; once complement C3 is activated, it causes a cascade of activation of C4 - C25. These activated proteins concentrate to form the granuloma.

C) Are immune cells that are normally synthesized to fight virus infections. In your patient's case, these cells were formed in response to ink particles.

D) Are proteins that recognize compounds unique to microbes or tissue damage; in your patient's case, these are made as a result of the tissue damage caused by the tattoo.

E) Are formed as an attempt by the body to wall off and contain persistent antigens - in his case, the red tattoo ink (red ink contains mercury compounds).