Antiperspirant‐related zirconium and aluminum‐containing granulomas; histopathology and in situ chemical analysis

Author:

Sanford Jeffrey A.1ORCID,Candelaria‐Santiago Roberto2,Forte Dominic M.3,Curcio Christian A.4,Allbritton Jill I.5,Strausborger Stacy L.6,Lewin‐Smith Michael R.6

Affiliation:

1. Department of Pathology Walter Reed National Military Medical Center Bethesda Maryland USA

2. Department of Pathology Carl R. Darnall Army Medical Center Fort Hood Texas USA

3. Department of Surgery Carl R. Darnall Army Medical Center Fort Hood Texas USA

4. Soft Tissue Pathology The Joint Pathology Center Silver Spring Maryland USA

5. Dermatopathology The Joint Pathology Center Silver Spring Maryland USA

6. Environmental Pathology The Joint Pathology Center Silver Spring Maryland USA

Abstract

AbstractThe potential adverse health effects of antiperspirant use are of interest to patients, primary care providers, dermatologists, and pathologists. In rare instances, antiperspirants containing aluminum–zirconium complexes have been associated with granulomatous dermatoses despite being deemed non‐sensitizing in experiments. In this case study, we present a detailed examination of an axillary granuloma in a 28‐year‐old female who had been using an aluminum–zirconium‐based antiperspirant for several years and presented with a left axillary nodule that was excised and analyzed using scanning electron microscopy with energy‐dispersive x‐ray analysis (SEM/EDXA). Histopathological examination revealed a foreign body‐type reaction with amphophilic granular material within giant cells that corresponded to collocated zirconium and aluminum on SEM/EDXA elemental maps. Our case adds to the limited reports of axillary granulomas related to aluminum–zirconium complexes. It illustrates the histopathological appearance and in situ distribution of the aluminum–zirconium complexes, supporting the formation of foreign body‐type granulomas. Additionally, our case study illustrates the potential role of these compounds in such reactions and aims to increase awareness among pathologists and clinicians.

Publisher

Wiley

Reference9 articles.

1. US Department of Health and Human Services.Antiperspirant drug products for over‐the‐counter human use. 21 CFR §350.2003Accessed June 28 2023.https://www.ecfr.gov/current/title-21/chapter-I/subchapter-D/part-350

2. Antiperspirant and deodorant allergy: diagnosis and management;Zirwas MJ;J Clin Aesthet Dermatol,2008

3. The effect of habitual and experimental antiperspirant and deodorant product use on the armpit microbiome

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