TY - JOUR

T1 - Adverse reactions after oral provocation with aluminium in children with vaccination granulomas and aluminium contact allergy

AU - Hoffmann, Stine Skovbo

AU - Elberling, Jesper

AU - Skamstrup Hansen, Kirsten

AU - Thyssen, Jacob P.

AU - Mortz, Charlotte G.

AU - Overgaard Bach, Rasmus

AU - Duus Johansen, Jeanne

N1 - This article is protected by copyright. All rights reserved.

PY - 2023

Y1 - 2023

N2 - BACKGROUND: According to their parents, some children with aluminium contact allergy and vaccination granulomas may react to aluminium-containing foods by developing dermatitis, granuloma itch and subjective symptoms.OBJECTIVES: To determine whether oral intake of aluminium-containing pancakes can cause adverse events and/or systemic contact dermatitis (SCD) in children with vaccination granulomas and aluminium contact allergy.PATIENTS/METHODS: A total of 15 children aged 3-9 years (mean age, 5 years) with vaccination granulomas and positive patch-test results to aluminium chloride hexahydrate 2%/10% pet. completed a 3-week blinded randomized controlled crossover oral aluminium/placebo provocation study with pancakes. Granuloma itch and other subjective symptoms were evaluated daily on a visual analogue scale (VAS). Dermatitis was evaluated by the primary investigator, and sleep patterns were tracked with an electronic device. Aluminium bioavailability was assessed by measuring aluminium excretion in the urine. The children served as their own controls with the placebo provocations.RESULTS: All 15 children completed the study. The mean VAS scores were slightly higher during aluminium provocations compared to placebo for granuloma itch (mean VAS, 1.5 vs 1.4, P = 0.6) but identical for other subjective symptoms (0.6 vs 0.6, P = 1). There were no differences in sleep patterns and no significant correlation between urinary aluminium excretion and symptom severity. Three children developed a symmetrical rash on the face or buttocks on day 4 of the aluminium provocations, but not during placebo provocations.CONCLUSIONS: No difference was found between oral aluminium intake and the occurrence of subjective symptoms and granuloma itch, but on a case-basis oral aluminium may be associated with the development of systemic contact dermatitis.

AB - BACKGROUND: According to their parents, some children with aluminium contact allergy and vaccination granulomas may react to aluminium-containing foods by developing dermatitis, granuloma itch and subjective symptoms.OBJECTIVES: To determine whether oral intake of aluminium-containing pancakes can cause adverse events and/or systemic contact dermatitis (SCD) in children with vaccination granulomas and aluminium contact allergy.PATIENTS/METHODS: A total of 15 children aged 3-9 years (mean age, 5 years) with vaccination granulomas and positive patch-test results to aluminium chloride hexahydrate 2%/10% pet. completed a 3-week blinded randomized controlled crossover oral aluminium/placebo provocation study with pancakes. Granuloma itch and other subjective symptoms were evaluated daily on a visual analogue scale (VAS). Dermatitis was evaluated by the primary investigator, and sleep patterns were tracked with an electronic device. Aluminium bioavailability was assessed by measuring aluminium excretion in the urine. The children served as their own controls with the placebo provocations.RESULTS: All 15 children completed the study. The mean VAS scores were slightly higher during aluminium provocations compared to placebo for granuloma itch (mean VAS, 1.5 vs 1.4, P = 0.6) but identical for other subjective symptoms (0.6 vs 0.6, P = 1). There were no differences in sleep patterns and no significant correlation between urinary aluminium excretion and symptom severity. Three children developed a symmetrical rash on the face or buttocks on day 4 of the aluminium provocations, but not during placebo provocations.CONCLUSIONS: No difference was found between oral aluminium intake and the occurrence of subjective symptoms and granuloma itch, but on a case-basis oral aluminium may be associated with the development of systemic contact dermatitis.

U2 - 10.1111/jdv.18811

DO - 10.1111/jdv.18811

M3 - Journal article

C2 - 36478462

VL - 37

SP - 1028

EP - 1035

JO - Journal of the European Academy of Dermatology and Venereology

JF - Journal of the European Academy of Dermatology and Venereology

SN - 0926-9959

IS - 6

ER -