title: [Post-vaccination granulomas caused by delayed-type reaction to aluminum salts].
abstract: BACKGROUND
  Aluminium salts are common adjuvants in all established inactivated vaccines. They are necessary to activate the humoral immune system. In the 1990s a Swedish study on an acellular vaccination against pertussis was started. Until 2013, 745 of 760,000 children with pruritic subcutaneous nodules were identified. In 77 % of these children a contact allergy to aluminium could be proven. Contact allergy to aluminium induced by vaccines causes pruritic subcutaneous nodules at the vaccination site. During infections of the upper respiratory tract the pruritus often escalates with inflammatory, erythematous and urticarial plaques.
  
  
  CONCLUSIONS
  The use of solutions containing aluminium salts for specific immunotherapy is contraindicated in the case of contact allergy to aluminium. Intramuscular injections of inactivated vaccines can be employed to avoid granuloma formation.
authors.affiliation: Klinik für Dermatologie und Allergologie, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland, rwahl@ukaachen.de.
authors.forename: R U
authors.initials: RU
authors.lastname: Wahl
authors.forename: G
authors.initials: G
authors.lastname: Wurpts
authors.forename: H F
authors.initials: HF
authors.lastname: Merk
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects; D000287:Administration, Topical; D000535:Aluminum / Q000008:administration & dosage / Q000009:adverse effects*; D018926:Anti-Allergic Agents / Q000008:administration & dosage; D017332:Cetirizine / Q000008:administration & dosage; D002675:Child, Preschool; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D003875:Drug Eruptions / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage; D006099:Granuloma / Q000139:chemically induced* / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D039563:Histamine H1 Antagonists, Non-Sedating / Q000008:administration & dosage; D006801:Humans; D008297:Male; D012492:Salts / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D014765:Viral Vaccines / Q000009:adverse effects* / Q000276:immunology
chemical_list: D000276:Adjuvants, Immunologic; D018926:Anti-Allergic Agents; D005938:Glucocorticoids; D039563:Histamine H1 Antagonists, Non-Sedating; D012492:Salts; D014765:Viral Vaccines; D000535:Aluminum; D017332:Cetirizine
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