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Aluminum recently was selected as the 2022 Allergen of the Year by the American Contact Dermatitis Society. Aluminum contact allergy, which most often is related to its use as an adjuvant in select vaccines and allergen-specific immunotherapies, tends to present with pruritic subcutaneous nodules at the injection site. Allergy to aluminum-containing antiperspirants manifests as axillary vault dermatitis. In this article, we highlight the growing recognition of aluminum contact allergy, particularly in the pediatric population, focusing on distinct presentations of aluminum allergic contact dermatitis (ACD), unique sources of exposure, and nuances of patch testing to this metal.

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