Sex: F
Vaccine: HPV4, HPV4
Symptoms: Pruritus, Skin fissures, Skin haemorrhage
Clinical narrative: atopic dermatitis/autoimmune dermatological issues with hands, red dry hands and fingers resulting in both hands having severe cracking, dryness, itching, redness; both hands bleeding; hands autoimmune dermatological issues; uncontrollable face and body twitching; Information has been received from a lawyer regarding a case in litigation referring to a 14-year-old female patient (pt). The pt's medical history was not reported. The pt's concurrent conditions were not reported. Concomitant therapies were not reported.  On unknown date, at the age of 14, the pt received the first dose of quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) (dose, route of administration, anatomical location, lot # and expiration date was not reported) for preventing cervical cancer, upon the recommendation of a physician and with the consent of her mother. Following the administration of the first dose, the pt developed autoimmune dermatological issues with hands.  On unknown date, the pt received the second dose of quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) (dose, route of administration, anatomical location, lot # and expiration date was not reported) for preventing cervical cancer. After the second dose, the pt's symptoms continued to persist and worsen with new developments including red dry hands and fingers resulting in both hands having severe cracking, dryness, itching, redness, and bleeding. The pt also developed uncontrollable face and body twitching. The pt was ultimately diagnosed with atopic dermatitis. The pt sought treatment from a variety of medical specialists to manage the conditions. The pt also contended sustained serious autoimmune injuries (autoimmune disorder) as a result of the quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injections. As a proximate result the quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL), the pt suffered and continued to suffer severe and permanent physical injuries and permanent emotional injuries, including pain and suffering. The pt also had a substantial fear of suffering additional and ongoing harms, including but not limited to now being at an increased risk of cancer, and future symptoms and harms associated with autoimmune disease and other injuries caused by quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL). As a direct and proximate result of the quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL)-induced injuries, the pt suffered and continued to suffer economic losses, including considerable financial expenses for medical care and treatment, and diminished income capacity, and would continue to incur these losses and expenses in the future. The outcome of all events was considered to be not recovered.  The lawyer considered all events to be related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL). The events of uncontrollable face and body twitching, atopic dermatitis, autoimmune disorder, skin bleeding were considered to be disabling by the lawyer.