Abstract
Aluminium hydroxide is used as an adjuvant in vaccines. We describe the case of a patient who presented a persistent adverse local reaction to aluminium hydroxide due to hyposensitization therapy to dust mites. Multiple painful and pruriginous subcutaneous nodules were observed in both arms, along with hypertrichosis at the injection site. Histology revealed a pseudolymphomatous B cell reaction predominantly involving cells that were CD20 positive, did not express bcl-2, and did not display the t(14-18) translocation. The cells also exhibited polyclonal rearrangement of the immunoglobulin heavy chains. X-ray spectral microanalysis revealed deposits of inorganic aluminium in the granular histiocytes among the germinal centers. The patient was diagnosed with cutaneous B-cell pseudolymphoma due to aluminium hydroxide as a result of immunotherapy.
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