Table 1.

Vaccinations associated with the subsequent development of erythema nodosum

Vaccine	References
Bacille–Calmette–Guerina	[13–15]
Hepatitis Bb	[16–18]
Human papillomavirusc	[19]
Malariad	[20]
Rabiese	[21, 22]
Smallpoxf	[23]
Tetanus, diphtheria, and pertussisg	Current report
Typhoid and cholerah	[24]

^aBacille–Calmette–Guerin (BCG) vaccine, a live attenuated vaccine derived from attenuated strains of Mycobacterium bovis, is used to prevent tuberculosis [13]. A retrospective study of etiologic factors associated with erythema nodosum in children was performed; BCG vaccination was the related etiology in 1 of 45 patients [14]. Another patient developed erythema nodosum 30 days after BCG vaccination; the local inflammatory reaction caused by the vaccine was normal [15]

^bErythema nodosum has been associated with administration of hepatitis B vaccine prepared either from human serum (Heptavax B^®, Merck & Co., Inc., Whitehouse Station, NJ, USA) [18] or by recombinant-DNA techniques (Engerix B, GlaxoSmithKline, Research Triangle Park, NC, USA [16] and Recombivax HB^®, Merck & Co., Inc., Whitehouse Station, NJ, USA [17])

^cA 16-year-old girl developed erythema nodosum after administration of vaccine against human papillomavirus types 6, 11, 16, and 18 (Gardasil^®, Merck & Co., Inc., Whitehouse Station, NJ, USA) [19]

^dTwo of 10 volunteers (a 25-year-old Asian woman and a 26-year-old Caucasian woman—both taking oral contraceptives) developed dermatology consultant-confirmed erythema nodosum after receiving 1 dose of 20 μg Pvs25/ISA 51 vaccine [a vaccine consisting of recombinant Pvs25 (a surface protein of mosquito stage of the malaria parasite Plasmodium vivax) which is formulated with Montanide ISA 51 (a water-in-oil emulsion)] [20]

^eAn 11-year-old girl developed erythema nodosum at the site of a dog bite after receiving a vaccination against rabies [22]. Another patient, 35-year-old woman developed biopsy-confirmed erythema nodosum a few days after receiving the second dose of a rabies vaccine treatment: Rabipur^® (Novartis Vaccines and Diagnostics, Cambridge, MA, USA), a purified chick embryo/second generation tissue culture vaccine [21]

^fThree patients are reported who developed cutaneous eruptions that were essentially varioliform, but ranged from erythema multiforme and erythema nodosum to severe hemorrhagic exanthems, on the 14th, 20th, and 22nd day after primary vaccination [23]

^gA 39-year-old woman developed erythema nodosum within 48 h after receiving a dose of the combined reduced-antigen content tetanus, diphtheria, and acellular pertussis (Tdap) vaccine [current report]

^hA 56-year-old woman developed pain and stiffness in both ankles, knees and lower back 24 h after receiving 0.5 ml of typhoid vaccine (to prevent salmonella infection) and 1.0 ml of cholera vaccine (to prevent cholera infection) intramuscularly; the symptoms were followed by the development of classical erythema nodosum on the anterior aspects of both lower legs [24]