Skin rash after triple vaccine is rare. We describe a child who developed a generalised asymptomatic rash after the second and third triple vaccine. Little information of the pathogenesis of the rash is available. We argue that the development of a rash is not a contraindication to future immunisation.

CASE PRESENTATION Mrs. Smith, a 56-year-old Caucasian woman, was seen in the office for complaints of a rash at her waist. She completed three cycles of dose-dense cyclophosphamide and doxorubicin chemotherapy for stage III breast cancer. The third cycle was 10 days prior. Grade III neutropenia was the only complete blood count abnormality.

Volume 88, Number 7 www.aafp.org/afp American Family Physician 457 A 41-year-old man presented with a painful, erythematous, erosive, and scaly rash. It was symmetrically distributed over sun-exposed areas, involving his face, neck, dorsum of his hands and feet, and upper back (Figures 1 and 2). The rash and frequent loose stools had been present for several months. Neuropsychiatric evaluation ...