BMJ Case Reports 2013; doi:10.1136/bcr-2012-007779

A child with a long-standing, intensely itching subcutaneous nodule on a thigh: an uncommon (?) reaction to commonly used vaccines

  1. Ulla Nyström Kronander3
  1. 1Research and Development Unit in Local Health Care, County of Östergötland, Linköping, Sweden
  2. 2Department of Clinical Pathology and Clinical Genetics, Experimental Pathology, Linköping, Sweden
  3. 3Allergy Centre, University Hospital, Linköping, Sweden
  1. Correspondence to Dr Elisabet Bergfors, elisabet.bergfors{at}
  • Received 23 October 2012
  • Revised 28 November 2012
  • Accepted 6 December 2012
  • Published 24 January 2013


A 2-year-old girl presented with an intensely itching subcutaneous nodule on the front of a thigh. The nodule persisted for 10 months until it was excised. Subsequent investigation for malignancy and systemic disease showed no pathological findings. The diagnosis, persistent itching vaccination granuloma, was revealed by hazard almost 2 years after the onset of symptoms. Persistent itching subcutaneous nodules at the injection site for aluminium containing vaccines (mostly diphtheria-tetanus-pertussis combination vaccines for primary immunisation of infants) may appear with a long delay after the vaccination (months), cause prolonged itching (years) and are often associated with contact allergy to aluminium. The condition is poorly recognised in Health Care which may lead to prolonged symptoms and unnecessary investigations.

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