Two case reports of cutaneous adverse reactions following hepatitis B vaccine: lichen planus and granuloma annulare

Criado, Paulo Ricardo; Ramos, Renata Pereira; Vasconcellos, Cídia; Criado, Roberta F. J.; Valente, Neusa Yuriko Sakai

doi:10.1111/j.1468-3083.2004.00989.x

Cited by 45 publications

(31 citation statements)

References 20 publications

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“…2 The etiology and pathogenesis, however, remain poorly understood. There have been reports of GA appearing after localized subcutaneous trauma for desensitization, 6 bacille Calmette-Gué rin vaccination, 7-10 tetanus and diphtheria vaccination, 11,12 hepatitis B vaccination, 13,14 ultraviolet light exposure, [15][16][17] mesotherapy, 18 and drug exposure. 16,[19][20][21][22][23] Studies have pointed to an immunologic mechanism with resultant necrobiosis underlying the development of GA.…”

Section: Etiopathogenesismentioning

confidence: 98%

Granuloma Annulare

Keimig

2015

Dermatologic Clinics

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Granuloma annulare (GA) is a noninfectious granulomatous skin condition that can present with a variety of cutaneous morphologies. It is characterized by collagen degeneration, mucin deposition, and palisaded or interstitial histiocytes. Although the mechanism underlying development of GA is unknown, studies point to a cell-mediated hypersensitivity reaction to an as-yet undetermined antigen. Systemic associations with diabetes, thyroid disorders, lipid abnormalities, malignancy, and infection are described in atypical GA. Treatment is divided into localized skin-directed therapies and systemic immunomodulatory or immunosuppressive therapies. The selected treatment modality should be based on disease severity, comorbid conditions, consideration of potential side effects, and patient preference.

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Section: Etiopathogenesismentioning

confidence: 98%

Granuloma Annulare

Keimig

2015

Dermatologic Clinics

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“…One of the main triggers of PS is the use of oral corticosteroid therapy, while AGEP is associated with macrolides and beta‐lactam‐based agents, and viral infections. Other triggers for AGEP include quinolones, sulfonamides, terbinafine, antimalarials, calcium channel blockers, non‐steroidal anti‐inflammatory drugs, spider bites and infections by parvovirus B19, cytomegalovirus, coxsackie B4, and mycoplasma pneumonia . Discriminating AGEP vs PS can dictate whether or not corticosteroids, cyclosporine and certain antibiotics are used (or avoided) in a patient's clinical management.…”

Section: Introductionmentioning

confidence: 99%

Distinguishing pustular psoriasis and acute generalized exanthematous pustulosis on the basis of plasmacytoid dendritic cells and MxA protein

et al. 2019

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Background Distinguishing acute generalized exanthematous pustulosis (AGEP) and pustular psoriasis (PS) can be challenging. Staining for plasmacytoid dendritic cells, or PDCs (producer of IFN‐α/β), and MxA (an IFN‐α/β inducible protein) may help discriminate these entities. Methods Forty‐three cases of AGEP and PS were compiled from two academic institutions. All cases were examined for CD123+ PDCs, eosinophils, acanthosis, papillomatosis, suprapapillary plate thinning, tortuous dilated capillaries, single necrotic keratinocytes, papillary dermal edema, vasculitis, eosinophil exocytosis, intraepidermal pustules, and subcorneal pustules. A subset of cases (n = 26) was stained for MxA. Results Perivascular and intraepidermal PDCs, dilated tortuous vessels, and MxA expression in the dermal inflammatory infiltrate were significantly (P < 0.05) in favor of a diagnosis of PS. The absence of PDCs and presence of eosinophils favored a diagnosis of AGEP (P < 0.05). Conclusions We found compelling evidence for the use of CD123 to highlight PDCs in these cases. The presence of PDCs and expression of MxA in dermal inflammatory infiltrate, as well as absence of eosinophils and presence of tortuous dilated capillaries favored a diagnosis of PS. Expression of MxA in the dermal infiltrate corresponds with a Th1 pathway in PS and may indicate a Th1 component in the early initial phase of AGEP.

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“…In contrast, pegylated interferon treatment for chronic hepatitis C was reported in two cases to trigger GA that resolved following end of therapy [9, 10], which suggests an immunogenic mechanism of GA. Hepatitis B vaccination has been associated with new onset GA in two cases [11, 12]. GA developed in sun exposed areas in two liver transplant recipients, 4 and 18 months after liver transplantation [13].…”

Section: Discussionmentioning

confidence: 99%

Chronic Hepatitis with Liver Granulomas in a Patient with Granuloma Annulare: A Case Report and Review of the Literature

Alsahafi

AlJasser

Kalia

et al. 2017

Case Reports in Gastrointestinal Medicine

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Granuloma annulare (GA) is a benign granulomatous skin disorder of unknown etiology. GA is rarely associated with liver diseases. We report a unique case of chronic hepatitis with liver granulomas in a patient with GA. Despite an extensive workup, no clear etiology for the hepatitis was found. Based on the possible immune pathophysiology of GA and the presence of liver granulomas, the patient was treated with prednisone and azathioprine which resulted in complete normalization of the liver enzymes and concurrent improvement of GA. The association between liver diseases and GA is reviewed.

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Two case reports of cutaneous adverse reactions following hepatitis B vaccine: lichen planus and granuloma annulare

Cited by 45 publications

References 20 publications

Granuloma Annulare

Granuloma Annulare

Distinguishing pustular psoriasis and acute generalized exanthematous pustulosis on the basis of plasmacytoid dendritic cells and MxA protein

Chronic Hepatitis with Liver Granulomas in a Patient with Granuloma Annulare: A Case Report and Review of the Literature

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