Skip to main content

47-Year-Old Given BCG Vaccine as a Child

  • Chapter
  • First Online:
Book cover Clinical Cases in Psoriasis

Part of the book series: Clinical Cases in Dermatology ((CLIDADE))

  • 497 Accesses

Abstract

Immunosuppressive therapy for psoriasis such as TNF inhibitors can increase the risk of tuberculosis. Patients should be screened for latent tuberculosis infection with a PPD skin test or IGRA. Those who have previously received the BCG vaccine should have an IGRA due to the chance of false positives. This was a case of a 47-year-old Filipino male with a history of BCG vaccine as a child.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, Gottlieb AB, Koo JY, Lebwohl M, Lim HW, Van Voorhees AS, Beutner KR, Bhushan R. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol. 2009;61(3):451–85. https://doi.org/10.1016/j.jaad.2009.03.027.

    Article  CAS  PubMed  Google Scholar 

  2. Fotiadou C, Lazaridou E, Ioannides D. Safety of anti-tumour necrosis factor-alpha agents in psoriasis patients who were chronic hepatitis B carriers: a retrospective report of seven patients and brief review of the literature. J Eur Acad Dermatol Venereol. 2011;25(4):471–4. https://doi.org/10.1111/j.1468-3083.2010.03754.x.

    Article  CAS  PubMed  Google Scholar 

  3. Keane J. TNF-blocking agents and tuberculosis: new drugs illuminate an old topic. Rheumatology (Oxford). 2005;44(6):714–20. https://doi.org/10.1093/rheumatology/keh567.

    Article  CAS  Google Scholar 

  4. Getahun H, Matteelli A, Chaisson RE, Raviglione M. Latent Mycobacterium tuberculosis infection. N Engl J Med. 2015;372(22):2127–35. https://doi.org/10.1056/NEJMra1405427.

    Article  CAS  PubMed  Google Scholar 

  5. Brassard P, Kezouh A, Suissa S. Antirheumatic drugs and the risk of tuberculosis. Clin Infect Dis. 2006;43(6):717–22. https://doi.org/10.1086/506935.

    Article  CAS  PubMed  Google Scholar 

  6. Keane J, Gershon S, Wise RP, Mirabile-Levens E, Kasznica J, Schwieterman WD, Siegel JN, Braun MM. Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent. N Engl J Med. 2001;345(15):1098–104. https://doi.org/10.1056/NEJMoa011110.

    Article  CAS  PubMed  Google Scholar 

  7. Gardam MA, Keystone EC, Menzies R, Manners S, Skamene E, Long R, Vinh DC. Anti-tumour necrosis factor agents and tuberculosis risk: mechanisms of action and clinical management. Lancet Infect Dis. 2003;3(3):148–55.

    Article  CAS  Google Scholar 

  8. Mazurek GH, Jereb J, Vernon A, LoBue P, Goldberg S, Castro K, IGRA Expert Committee; Centers for Disease Control and Prevention (CDC). Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection—United States, 2010. MMWR Recomm Rep. 2010;59(RR-5):1–25.

    PubMed  Google Scholar 

  9. Koca R, Altinyazar HC, Numanoglu G, Unalacak M. Guttate psoriasis-like lesions following BCG vaccination. J Trop Pediatr. 2004;50(3):178–9. https://doi.org/10.1093/tropej/50.3.178.

    Article  PubMed  Google Scholar 

  10. Takayama K, Satoh T, Hayashi M, Yokozeki H. Psoriatic skin lesions induced by BCG vaccination. Acta Derm Venereol. 2008;88(6):621–2. https://doi.org/10.2340/00015555-0496.

    Article  PubMed  Google Scholar 

  11. Centers for Disease Control and Prevention. Recommendations for use of an isoniazid-rifapentine regimen with direct observation to treat latent Mycobacterium tuberculosis infection. MMWR Morb Mortal Wkly Rep. 2011;60(48):1650–3.

    Google Scholar 

  12. Wallis RS, Broder M, Wong J, Beenhouwer D. Granulomatous infections due to tumor necrosis factor blockade: correction. Clin Infect Dis. 2004;39(8):1254–5. https://doi.org/10.1086/424455.

    Article  PubMed  Google Scholar 

  13. Menter A, Thaci D, Papp KA, Wu JJ, Bereswill M, Teixeira HD, Rubant S, Williams DA. Five-year analysis from the ESPRIT 10-year postmarketing surveillance registry of adalimumab treatment for moderate to severe psoriasis. J Am Acad Dermatol. 2015;73(3):410–419 e416. https://doi.org/10.1016/j.jaad.2015.06.038.

    Article  CAS  PubMed  Google Scholar 

  14. Doherty SD, Van Voorhees A, Lebwohl MG, Korman NJ, Young MS, Hsu S, National Psoriasis F. National Psoriasis Foundation consensus statement on screening for latent tuberculosis infection in patients with psoriasis treated with systemic and biologic agents. J Am Acad Dermatol. 2008;59(2):209–17. https://doi.org/10.1016/j.jaad.2008.03.023.

    Article  PubMed  Google Scholar 

  15. Tsai TF, Ho V, Song M, Szapary P, Kato T, Wasfi Y, Li S, Shen YK, Leonardi C, Phoenix PAP, Japanese Ustekinumab Study Group. The safety of ustekinumab treatment in patients with moderate-to-severe psoriasis and latent tuberculosis infection. Br J Dermatol. 2012;167(5):1145–52. https://doi.org/10.1111/j.1365-2133.2012.11142.x.

    Article  CAS  PubMed  Google Scholar 

  16. Griffiths CE, Reich K, Lebwohl M, van de Kerkhof P, Paul C, Menter A, Cameron GS, Erickson J, Zhang L, Secrest RJ, Ball S, Braun DK, Osuntokun OO, Heffernan MP, Nickoloff BJ, Papp K, UNCOVER-2 and UNCOVER-3 investigators. Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis (UNCOVER-2 and UNCOVER-3): results from two phase 3 randomised trials. Lancet. 2015;386(9993):541–51. https://doi.org/10.1016/S0140-6736(15)60125-8.

    Article  CAS  PubMed  Google Scholar 

  17. van de Kerkhof PC, Griffiths CE, Reich K, Leonardi CL, Blauvelt A, Tsai TF, Gong Y, Huang J, Papavassilis C, Fox T. Secukinumab long-term safety experience: a pooled analysis of 10 phase II and III clinical studies in patients with moderate to severe plaque psoriasis. J Am Acad Dermatol. 2016;75(1):83–98 e84. https://doi.org/10.1016/j.jaad.2016.03.024.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lee, M.P., Wu, K.K., Wu, J.J. (2019). 47-Year-Old Given BCG Vaccine as a Child. In: Wu, J. (eds) Clinical Cases in Psoriasis. Clinical Cases in Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-030-18772-9_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-18772-9_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-18771-2

  • Online ISBN: 978-3-030-18772-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics