title: There is an association between contact allergy to aluminium and persistent subcutaneous nodules in children undergoing hyposensitization therapy.
abstract: BACKGROUND
  The development of persistent itchy nodules at the injection site following hyposensitization therapy with aluminium-precipitated antigen extract has been described in several reports. Occasionally, contact allergy to aluminium has been reported in individuals with such nodules.
  
  
  OBJECTIVE
  To investigate if hyposensitization therapy can induce contact allergy to aluminium and examine if there is any association between persistent subcutaneous nodules and aluminium allergy.
  
  
  METHODS
  Sixty-one children with allergic asthma and/or allergic rhinitis participated in the study of whom 37 had had hyposensitization therapy. The study consisted of a non-clinical part based on a questionnaire and a clinical part with a physical examination, self-assessment of itching, and patch testing. To secure an unbiased evaluation of possible reactions, the investigators were blinded.
  
  
  RESULTS
  Contact allergy to aluminium was found in eight participants, all in the exposed group (8/37 versus 0/24, P = 0.02). Examination showed nodules on the upper arms in 13 participants, all in the group exposed to hyposensitization therapy. Nodules were over-represented in patients with contact allergy to aluminium.
  
  
  CONCLUSIONS
  There was a statistically significant association between contact allergy to aluminium and persistent subcutaneous nodules in children who had had hyposensitization therapy.
authors.affiliation: Department of Clinical Sciences in Malmö, Faculty of Medicine, Lund University, Lund, Sweden. eva.netterlid@med.lu.se
authors.forename: Eva
authors.initials: E
authors.lastname: Netterlid
authors.forename: Monica
authors.initials: M
authors.lastname: Hindsén
authors.forename: Jonas
authors.initials: J
authors.lastname: Björk
authors.forename: Susanne
authors.initials: S
authors.lastname: Ekqvist
authors.forename: Nuray
authors.initials: N
authors.lastname: Güner
authors.forename: Kent Ake
authors.initials: KA
authors.lastname: Henricson
authors.forename: Magnus
authors.initials: M
authors.lastname: Bruze
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000535:Aluminum / Q000009:adverse effects*; D016009:Chi-Square Distribution; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology* / Q000276:immunology / Q000628:therapy*; D003888:Desensitization, Immunologic / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D015994:Incidence; D008297:Male; D010328:Patch Tests / Q000009:adverse effects*; D011336:Probability; D011537:Pruritus / Q000139:chemically induced / Q000453:epidemiology* / Q000473:pathology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000535:Aluminum