Cytophagic histiocytic panniculitis after H1N1 vaccination: a case report and review of the cutaneous side effects of influenza vaccines

Dermatology. 2011;222(3):217-20. doi: 10.1159/000326912. Epub 2011 Apr 13.

Abstract

Cytophagic histiocytic panniculitis (CHP) is a rare disease mostly caused by viral infections and/or lymphoproliferative diseases. We describe a case of CHP associated with H1N1 vaccine during the winter 2009-2010 vaccination campaign and discuss the cutaneous side effects of influenza vaccines. A 6-year-old child presented with inflammatory subcutaneous nodules, which had appeared 1 month after the first injection of H1N1 vaccine and 1 week after the second injection. There was no history of recent infection. The skin lesions spontaneously disappeared without scarring. In CHP the abnormal cytokine secretion from neoplastic or reactive T cells promotes monocyte-macrophage activation and haemophagocytosis. Vaccination is not a common cause of CHP, but it seems possible that, as in infectious diseases, reactive T cells to the vaccine antigen could trigger CHP.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Child
  • Granzymes / immunology
  • Granzymes / metabolism
  • Histiocytes / metabolism
  • Histiocytes / pathology
  • Histiocytosis / etiology*
  • Histiocytosis / metabolism
  • Histiocytosis / pathology
  • Humans
  • Influenza A Virus, H1N1 Subtype / immunology*
  • Influenza Vaccines / adverse effects*
  • Influenza Vaccines / immunology
  • Male
  • Panniculitis / etiology*
  • Panniculitis / immunology
  • Panniculitis / pathology
  • Remission, Spontaneous
  • T-Lymphocytes, Cytotoxic / metabolism
  • T-Lymphocytes, Cytotoxic / pathology

Substances

  • Influenza Vaccines
  • Granzymes