Immune-mediated pathology following hepatitis B vaccination. Two cases of polyarteritis nodosa and one case of pityriasis rosea-like drug eruption

The association of hepatitis B virus infection and vasculitis or other immu ne-mediated manifestations is well documented. Reports on such manifestatio ns in relation to hepatitis B vaccination are scarce, however. We report 2 patients who developed polyarteritis nodosa following vaccination against h epatitis B. In one patient this resulted in an ischemic and necrotic digita l ulcus, necessitating surgical amputation. The other patient presented wit h typical cutaneous polyarteritis nodosa which responded well to corticoste roid treatment. A third patient developed a severe pityrias rosea-like erup tion. He was treated with topical steroids with healing of the lesions, lea ving only post-inflammatory hyperpigmentation. The literature on these asso ciations is reviewed.