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Depression: 21st Century Solutions + The Dark Side of Wheat

Abstract Title:

A case of extensive ulcerating vasculitis following a BCG vaccination.

Abstract Source:

J Plast Reconstr Aesthet Surg. 2009 Aug;62(8):e286-9. Epub 2007 Dec 31. PMID: 18166508

Abstract Author(s):

A Ghattaura, K A Eley, E Molenaar, G Smith

Article Affiliation:

Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK. amarghatt@hotmail.com

Abstract:

Adverse reactions following BCG vaccination are uncommon, with an estimated prevalance of 0.4 per 1000 vaccines [Lotte A, Wasz-Hockert O, Poisson N, et al. Second IUATLD study on complications induced by intradermal BCG vaccination. Bull Int Union Tuber 1988;63:47-59]. Complications include erythema, blistering, abscess formation, regional lymphadenitis and keloid formation. The onset of cutaneous tuberculosis (TB) has also been reported. We describe the case of 12-year-old girl who developed extensive primary ulceration involving most of her left upper arm at the site of a BCG vaccination. A skin graft to the arm failed to take at the periphery and the ulcerated area increased to involve most of the upper lateral arm. Over a period of 18 months, secondary lesions developed on her forehead prompting further investigation of a systemic disease process. Following extensive immunological and microbiological examination, a diagnosis of vaccine-induced granulomatous vasculitis was made and the patient responded to a combination of antituberculous therapy and steroids. Once the disease process was under control, skin grafting of the ulcerated area was successful in achieving wound closure. Non-healing ulceration may be referred to the plastic surgeon and a diagnosis of vasculitis should be considered in difficult cases. A multidisciplinary team approach involving immunologists, dermatologists and plastic surgeons provides the best opportunity for a successful long-term outcome in terms of disease control as well as immediate skin cover.

Study Type : Human: Case Report

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Sayer Ji
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Depression: 21st Century Solutions + The Dark Side of Wheat

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