A pseudolymphomatous reaction is an unusual immune response that can be caused by a tattoo, most commonly by red ink. We present the case of a 40-year-old woman with discolored and pruritic plaques in the areas of red ink tattooed on her right ankle that developed shortly after tattoo application. The patient had 2 other tattoos with red ink for more than 20 years without any disfigurement. Histopathology, immunohistochemistry, and polymerase chain reaction analysis from biopsy of the affected area showed polyclonal pseudolymphomatous and lichenoid reaction, confirming the diagnosis of pseudolymphoma secondary to a tattoo. Total excision of the lesion was performed.