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Foreign body reaction involving a Mantoux test site
Youngjin Kim1, Elizabeth Dawes-Higgs, Samuel Zagarella
1Department of Dermatology, Concord Hospital, Sydney, New South Wales, Australia. kimabel@hanmail.net
The Australasian Journal of Dermatology
|July 13, 2005
Summary
A rare skin reaction occurred after a Mantoux test due to keratin or hair implantation. This foreign body reaction caused a persistent pustular lesion at the injection site.
Area of Science:
- Dermatology
- Pathology
- Infectious Disease
Background:
- The Mantoux test, an intradermal injection of tuberculin purified protein derivative, is a standard diagnostic tool for tuberculosis.
- Adverse skin reactions, though uncommon, can occur at injection sites.
Observation:
- A 41-year-old woman developed a solitary pustular erythematous lesion 10 months post-Mantoux testing.
- Histopathology revealed a suppurative reaction with foreign body giant cells, specifically reacting to keratin flakes.
Findings:
- Tissue cultures were negative for aerobic, anaerobic, and mycobacterial organisms.
- The reaction was attributed to the potential implantation of epidermal keratin or hair into the dermis during the injection process.
Implications:
- This case highlights a rare foreign body reaction mimicking infection after intradermal injections.
- It underscores the importance of considering iatrogenic causes for persistent inflammatory lesions at injection sites.
- Further investigation into injection techniques may help prevent such delayed cutaneous reactions.