Post-vaccination aluminium granulomas in children. / Aluminiumsgranulomer etter barnevaksinasjon.

BACKGROUND: Persistent itching subcutaneous granulomas related to aluminium-containing vaccines are poorly recognised in health care. They are often associated with aluminium hypersensitivity. CASE PRESENTATION: An intensely itching subcutaneous nodule appeared on the left thigh of a 17-month-old girl at the injection site for an aluminium adsorbed diphtheria-tetanus-pertussis-polio-HiB vaccine given at 3, 5 and 12 months. Ultrasound suggested a vascular malformation among other differential diagnoses. An MR investigation under general anaesthesia was planned, but the diagnosis was confirmed prior to this by a positive epicutaneous test with aluminium. INTERPRETATION: Despite a typical history of an itchy vaccination granuloma, the child underwent a thorough hospital workup to rule out malignancy. The diagnosis was delayed for two years. Vaccination granulomas have a good prognosis but can persist for many years. It is important to recognise the condition early in primary health care to avoid unnecessary anxiety and investigations.

[Contact allergy to henna tattoos]. / Kontaktallergi mot hennatatovering.

BACKGROUND: Tattoos with henna colours have become very popular and the prevalence of contact allergy seems to increase. MATERIAL AND METHODS: This is a short review article based on our own clinical experience and literature identified through a search in PubMed with the words "henna", "paraphenylendiamin" and "allergic contact dermatitis." A case report is included. RESULTS: It is well documented that many experience skin reactions after henna tattoos. The cause is almost always contact allergy to the azo compound paraphenylendiamin, which is added to speed up the process and make the colour darker. Most people, including children, get henna tattoos during vacations in Asia or the Mediterranean. Established contact allergy is permanent. Many hair-colour products contain paraphenylendiamin, and persons with contact allergy against the product may develop a very strong contact allergic eczema by use of such substances. Acute reactions are treated with local cortisone products, or with systemic steroids. Cross reaction to substances with a similar chemical structure may occur. INTERPRETATION: Tattoos with paraphenylendiamin-containing henna colours should be avoided.

Variability in patch test reactions--first report from the Norwegian Patch Test Registry.

BACKGROUND: A nation-wide Norwegian Patch Test Registry (NOLAR) was established in 2005 as a collaboration between six dermatology departments. International, multi-centre studies have documented great variability in the frequency of positive patch test reactions, considered as mainly due to heterogeneity of test populations. OBJECTIVES: To analyse the variability of positive test reactions by studying patch tests performed at the six collaborating departments, using standardized procedures. MATERIALS AND METHODS: Data from all patch tests (n = 2089) performed in 2007-2008 as registered in the NOLAR program. Differences between centres were analysed using Exact Pearson chi(2) test. RESULTS: Between the centres, positive test reactions (+, ++, or +++) varied significantly for 8 of the 26 allergens in the European Baseline Series. When considering strong reactions (++ or +++) only, the differences were statistically significant for six of these allergens, i.e. cobalt chloride, potassium dichromate, p-phenylenediamine, formaldehyde, paraben mix, and mercaptobenzothiazole. CONCLUSION: The results indicate regional differences in the prevalence of sensitization to certain allergens within the Norwegian population, although inter-observer differences cannot be ruled out as a factor.