Delayed‐type hypersensitivity to vaccine aluminum adjuvant causing subcutaneous leg mass and urticaria in a child.

Gordon, Samantha C.; Song, Johanna S.; Hawryluk, Elena B.; Bartenstein, Diana W.; Tajmir, Shahein H.

Abstract: 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 DTaP‐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.

ALLERGIES; ITCHING; URTICARIA; VACCINES; CHILDREN

Pediatric Dermatology, 2018, Vol 35, Issue 2, p234

0736-8046

Academic Journal

10.1111/pde.13390