Can some one develop an allergy to PPD?

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Specializes in Ante-Intra-Postpartum, Post Gyne.

Is it possible to build up an allergy to PPD? Granted I have had approx 12 TB skin tests since 2000 and will get one every year for the rest of my life; is it possible to develop and allergy to PPD? This is the second time I have gotten a red raised area just under the size of a quarter the evening after getting a TB test. It looks exactly the same as last time and last time it was gone the next day and stayed gone. It has happened again but this time I have a runny nose; which could just be coincidence. I took a picture of it but I did not know if I could post it; I am not asking for medical advise...I am just curious.

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Specializes in Stroke Seizure/LTC/SNF/LTAC.

Yes, you can. You might also be allergic to the preservative in the PPD. I once had 3 PPD's within about a month (new hire, signed up for agency, then step 2). I had a very itchy, somewhat raised area around where the shot was placed. It went away, but it sure wasn't fun. The forms my former employer used asked about allergies to phenol/tween. Phenol and tween are preservatives.

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The first thing that comes to mind is that you are positive for exposure to TB? Hopefully you told someone that you had a reaction, but it disappeared before they read it?

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Specializes in Ante-Intra-Postpartum, Post Gyne.
The first thing that comes to mind is that you are positive for exposure to TB? Hopefully you told someone that you had a reaction, but it disappeared before they read it?

If it is positive then it will be positive when it shows up to be read. There is nothing there by the 72 hrs, its only the first 12 hrs or so. At least that is how it was last time. And I have very sensitive skin.

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I'm allergic to it, but mine doesn't clear up for a week. It gets red and raised, but not hard. It's done this since my second or third shot.

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Specializes in Nurse Scientist-Research.

The employee health where I work often diagnoses nickel allergies when they get a certain type of reaction to the PPD. They say they have a way of distinguishing it from a true positive reaction. I doubt their capability of distinguishing the difference though I do believe there is such a thing as a nickel reaction. I'm guessing nickel is one of the preservatives used in the PPD.

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The employee health where I work often diagnoses nickel allergies when they get a certain type of reaction to the PPD. They say they have a way of distinguishing it from a true positive reaction. I doubt their capability of distinguishing the difference though I do believe there is such a thing as a nickel reaction. I'm guessing nickel is one of the preservatives used in the PPD.

I'm not sure what my allergy is to, but the employee health nurse said there had to be induration (it had to be hard). Mine never is, so that's how they determined I'm not actually positive.

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Specializes in mental health, military nursing.

A lot of people develop a sensitivity to PPD tests, especially if they've had a lot of them. Usually it doesn't contraindicate future tests, unless you have a severe reaction. For one of my employees, her whole arm turns red and swollen.

There is a clear distinction between an allergy and a positive test... An easy way to tell:

If the reaction begins within the first hour and begins clearing up within the first few hours (or with a Benadryl), you've got a sensitivity to the Tubersol. Test site usually becomes red and a little itchy with no clear border.

A positive test will be positive 48-72 hours after the test, and forms a hard, red, raised area with very clear edges. It actually looks like a little plateau.

Once you've seen a positive TB test, you can't mix the two up - it's pretty weird looking!

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Specializes in Med Surg-Geriatrics.

We have had several long term residents who have developed an allergy to PPD solution

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Specializes in Flight, ER, Transport, ICU/Critical Care.

:eek:

Yes.

Strange background from my case - hopefully you do not have any so convoluted - I had a "reaction" as a teen - it was an odd situation, my uncle who had lived with us briefly when I was in grade school had a TB diagnosis and was treated for months. The TB was discovered a few months after he had moved from our home and it turned into a siege from the public health department. My dad and uncle had been exposed to TB via cow milk as children and the medical mystery began. The health department had mandatorily monitored my family for several years - my mom was a nurse and I'm certain that all precautions were being taken - these included regular testing starting as a child - they used to do a "tine" test and then the PPD came later. No one in my family had tested positive & my mom was firmly reluctant to allow my sister and I to endure months of INH as a precaution. So serial monitoring was the plan.

I had been tested for over 8 years - when I had a reaction to the PPD. Within a few hours of receiving the test, I was covered in whelps and itchy and wheezy. I then developed a blistery like rash from the PPD site that extended up my arm, across my chest and back - covered parts of my face and upper leg that lasted for over 2 weeks. Public health was all over it, there was lots of testing (I had severe allergies as a child - had to remove carpets, drapes - my family had to make exceptional efforts because I had such reactions to many, many things) - I needed weeks of treatment for the reaction. It was deemed to be an ALLERGY and I was told to NEVER take another PPD (that part about it could kill me really stuck in my head!). They felt it was not a reaction to any additive but the proteins in the PPD itself. I have never taken another PPD. I do a CXR every 2 years and monitor of any symptoms. I also take precautions with all respiratory patients - cause I do not have a good way to police for TB. I do not smoke and avoid being in situations that irritate my lungs.

I know this is a lot of story - but, although extreme - it illustrates that allergy is more than possible.

Of course the allergy could be to an additive, but I think I would run it by a specialist and take steps to NOT TAKE ANY CHANCES. In the event that you have have a true allergy - it is risky to continue. I would not take any chances and consider the days of PPD testing over and move toward alternate monitoring (CXR and sx monitoring).

Good Luck.

;)

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the last time I let anyone gave me a PPD was 2008...I had a reaction, it was huge, hard, reddened, swollen, very itchy, took weeks to go away, and it left a scar...I knew I would get positive result from PPD because of BCG vaccination when I was young, but because I read that BCG goes away after sometime, I was curious and so I got a PPD test...I think I'm going to stick to chest xrays from now on...

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Specializes in Critical Care.

I have been allergic to one of the preservatives (dunno which) for some time, and I have dealt with them because I don't know if getting an annual CXR is better for my health than a SC injection of a substance my body clearly recognizes as toxic?

Phenol and chinosol are the preservatives, btw.

I buy benadryl ointment to celebrate my annual WEEK OF ITCHY ARM, woohoo!!

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