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Clinical Notes
December 7, 1964

Granulomatous Hypersensitivity After Use of Zirconium-Containing Poison Oak Lotions

JAMA. 1964;190(10):940-942. doi:10.1001/jama.1964.03070230076029

OF THE METALS to which man is exposed, only zirconium and beryllium are known to induce delayed granulomatous hypersensitivity. Historically, axillary granulomas following the application of zirconium-containing stick deodorants1-4 drew attention to this metal as a cause of allergic granulomas.5-8 More recent cases have masqueraded as sarcoidosis.9-11 In this report we describe another instance of presumed sarcoidosis due in fact to granulomatous hypersensitivity to zirconium in a topical remedy for poison oak dermatitis.

Report of a Case  A 16-year-old Japanese girl presented with a nonpruritic papular eruption of four months' duration on the face, forearms, and the dorsum of her hands. The lesions appeared as large, reddish-brown, flat-topped papules, 3 to 6 mm in diameter (Fig 1. Note: No topical therapy was used at this point.). She showed no signs of systemic illness. A biopsy revealed a "noncaseating dermal granuloma consistent with sarcoidosis." The clinical diagnosis was

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