An Unexpected Post-Egg-Free Influenza Vaccine Granulomatous Reaction.
| Autor: | Engel CE; Virginia Tech Carilion School of Medicine, Roanoke, VA., Fagan KK; Department of Dermatology, Emory School of Medicine, Atlanta, GA., Dorsey SB; Dermatology Section, Department of Internal Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA., Grider DJ; Dermatology Section, Department of Internal Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA.; Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, VA; and.; Dominion Pathology Associates, Roanoke, VA. |
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| Jazyk: | angličtina |
| Zdroj: | The American Journal of dermatopathology [Am J Dermatopathol] 2024 Aug 01; Vol. 46 (8), pp. e63-e65. Date of Electronic Publication: 2024 Jun 06. |
| DOI: | 10.1097/DAD.0000000000002751 |
| Abstrakt: | Abstract: A 53-year-old woman presented with a pruritic plaque on the left upper arm that appeared following an egg-free flu vaccine due to a history of reaction to the standard vaccine. The affected area enlarged over a several month period immediately following vaccine administration. Physical examination revealed an 8 × 4 cm coalescent pink plaque on the left upper arm. A shave biopsy of the lesion showed dermal "naked" granulomas, or granulomas with sparse lymphocytic infiltrate at the margins, as typically seen in sarcoidosis. No foreign material was seen in the granulomatous reaction, including with polarization. Special stains, including acid fast bacilli, Grocott methenamine silver, periodic acid-Schiff, and Gram, were negative for organisms. The diagnosis of granulomatous dermatitis was made. Subsequent imaging demonstrated no findings suggestive of sarcoidosis. While vaccine-associated hypersensitivity reactions occur frequently, these reactions are typically due to individual vaccine components, such as egg protein, and do not normally result in the formulation of granulomas. Vaccination-induced granulomas are more often associated with the use of aluminum as an adjuvant; however, this is not present in the egg-free influenza vaccine. Thus, a granulomatous reaction to the egg-free influenza vaccine is very unusual and, to our knowledge, not previously reported. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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