Pilomatricoma Arising at a BCG Vaccination Site

The document describes a rare case of pilomatricoma, a benign hair-follicle tumor, arising at the site of a BCG vaccination in a 13-year-old white girl. The vaccination site had not healed properly and showed signs of ulceration and purulent discharge. Initially treated for presumed BCG-associated lupus vulgaris, the lesion did not resolve until it was later diagnosed as pilomatricoma through biopsy and excised completely. This association between pilomatricoma and BCG vaccination had not been previously reported. The authors suggest that pilomatricoma should be considered in the differential diagnosis of chronic ulcerating lesions at BCG vaccination sites. The patient had no recurrence of the lesion at a 2-month follow-up visit. The document emphasizes that while BCG vaccination rarely causes significant cutaneous complications, pilomatricoma can present in a variety of ways and may be associated with trauma or persistent inflammation.