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Delayed‐type hypersensitivity to vaccine aluminum adjuvant causing subcutaneous leg mass and urticaria in a child
Author(s) -
Gordon Samantha C.,
Bartenstein Diana W.,
Tajmir Shahein H.,
Song Johanna S.,
Hawryluk Elena B.
Publication year - 2018
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.13390
Subject(s) - medicine , erythema , dermatology , medical history , adjuvant , physical examination , surgery
A 3‐year‐old girl presented with a 7‐month history of a waxing and waning left thigh mass associated with pruritus and erythema at the site of two previous DT aP‐HepB‐ IPV vaccinations. Patch testing was positive to aluminum chloride, supporting a diagnosis of vaccine granuloma secondary to aluminum allergy; her symptoms had been well controlled with antihistamines and topical steroids. Injection site granulomas are a benign but potentially bothersome reaction to aluminum‐containing immunizations that can be supportively managed, and we encourage strict adherence to the recommended vaccine schedule in this setting. Patch testing is a sensitive, noninvasive diagnostic tool for patients presenting with this clinical finding, and dermatologist awareness can prevent unnecessary medical examination and provide reassurance.

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