Cutaneous findings following COVID‐19 vaccination: review of world literature and own experience

Journal of the European Academy of Dermatology and Venereology, Journal Year: 2021, Volume and Issue: 36(2), P. 172 - 180

Published: Oct. 19, 2021

There is growing evidence that not only the novel coronavirus disease (COVID-19) but also COVID-19 vaccines can cause a variety of skin reactions. In this review article, we provide brief overview on cutaneous findings have been observed since emerging mass vaccination campaigns all over world. Unspecific injection-site reactions very early occurring after are most frequent. Type I hypersensitivity (e.g. urticaria, angio-oedema and anaphylaxis) likely due to allergy ingredients may rarely occur be severe. IV observed, including delayed large local lesions ("COVID arm"), inflammatory in dermal filler or previous radiation sites even old BCG scars, more commonly morbilliform erythema multiforme-like rashes. Autoimmune-mediated include leucocytoclastic vasculitis, lupus erythematosus immune thrombocytopenia. Functional angiopathies (chilblain-like lesions, erythromelalgia) observed. Pityriasis rosea-like rashes reactivation herpes zoster reported vaccination. conclusion, there numerous reaction patterns following vaccination, whereby many these immunological/autoimmunological nature. Importantly, molecular mimicry exists between SARS-CoV-2 spike-protein sequences used design vaccines) human components thus explain some pathologies as well adverse vaccinations.

Language: Английский

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Clinical and pathologic correlation of cutaneous COVID-19 vaccine reactions including V-REPP: A registry-based study

Journal of the American Academy of Dermatology, Journal Year: 2021, Volume and Issue: 86(1), P. 113 - 121

Published: Sept. 10, 2021

Cutaneous reactions after COVID-19 vaccination have been commonly reported; however, histopathologic features and clinical correlations not well characterized.We evaluated for a history of skin biopsy all reports associated with identified in an international registry. When histopathology were available, we categorized them by reaction patterns.Of 803 vaccine reported, 58 (7%) cases had available review. The most common pattern was spongiotic dermatitis, which clinically ranged from robust papules overlying crust, to pityriasis rosea-like eruptions, pink fine scale. We propose the acronym "V-REPP" (vaccine-related eruption plaques) this spectrum. Other patterns included bullous pemphigoid-like (n = 12), dermal hypersensitivity 4), herpes zoster lichen planus-like pernio 3), urticarial 2), neutrophilic dermatosis leukocytoclastic vasculitis morbilliform delayed large local erythromelalgia 1), other 5).Cases represented minority registry entries. Analysis data cannot measure incidence.Clinical correlation allowed categorization cutaneous vaccine. defining subset vaccine-related plaques, as 12 patterns, following vaccination.

Language: Английский

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Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective

Vaccines, Journal Year: 2021, Volume and Issue: 9(9), P. 944 - 944

Published: Aug. 25, 2021

(1) Background: Numerous vaccines are under preclinical and clinical development for prevention of severe course lethal outcome coronavirus disease 2019 (COVID-19). In light high efficacy rates satisfactory safety profiles, some agents have already reached approval now distributed worldwide, with varying availability. Real-world data on cutaneous adverse drug reactions (ADRs) remain limited. (2) Methods: We performed a literature research concerning ADRs to different COVID-19 vaccines, incorporated our own experiences. (3) Results: Injection site the most frequent side effects arising from all vaccine types. Moreover, delayed may occur after several days, either as primary manifestation or flare pre-existing inflammatory dermatosis. Cutaneous be divided according their cytokine profile, based preponderance specific T-cell subsets (i.e., Th1, Th2, Th17/22, Tregs). Specific mimic immunogenic natural infection SARS-CoV-2, which is associated an abundance type I interferons. (4) Conclusions: Further studies required in order determine best suitable individual groups patients, including patients suffering chronic dermatoses.

Language: Английский

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A systematic review on mucocutaneous presentations after COVID‐19 vaccination and expert recommendations about vaccination of important immune‐mediated dermatologic disorders

Dermatologic Therapy, Journal Year: 2022, Volume and Issue: 35(6)

Published: March 22, 2022

With dermatologic side effects being fairly prevalent following vaccination against COVID-19, and the multitude of studies aiming to report analyze these adverse events, need for an extensive investigation on previous seemed urgent, in order provide a thorough body information about post-COVID-19 immunization mucocutaneous reactions. To achieve this goal, comprehensive electronic search was performed through international databases including Medline (PubMed), Scopus, Cochrane, Web science, Google scholar July 12, 2021, all articles regarding manifestations considerations after COVID-19 vaccine administration were retrieved using keywords: vaccine, dermatology manifestations. A total 917 records final number 180 included data extraction. Mild, moderate, severe potentially life-threatening events have been reported with COVID vaccines, case reports, series, observational studies, randomized clinical trials, further recommendations consensus position papers vaccination. In systematic review, we categorized results detail into five elaborate tables, making what believe be extensively informative, unprecedented set topic. Based our findings, viewpoint pros cons vaccination, mostly non-significant, self-limiting reactions, more uncommon moderate guidelines could great importance those at higher risks specific worries flare-ups or inefficient immunization, sufficient safely schedule their doses, avoid if they discussed contra-indications.

Language: Английский

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New Onset and Exacerbations of Psoriasis Following COVID-19 Vaccines: A Systematic Review

American Journal of Clinical Dermatology, Journal Year: 2022, Volume and Issue: 23(6), P. 775 - 799

Published: Sept. 1, 2022

Language: Английский

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Cutaneous manifestations following COVID‐19 vaccination: A report of 25 cases

Dermatologic Therapy, Journal Year: 2022, Volume and Issue: 35(8)

Published: June 18, 2022

Various adverse effects particularly cutaneous manifestations associated with different COVID-19 vaccines have been observed in practice. The aim of our study was to evaluate all patients who presented tertiary center skin following injection from September December 2021. All manifestation within 30 days or less vaccination were enrolled case-series. cases included diagnosed based on clinical and/or histopathological evaluation and other possible differential diagnoses ruled out. Twenty-five individuals including 16 (64%) males 9 (36%) females the mean age 47 ± 17.62 years (range 18-91) study. Twenty-two (88%) developed lesions after Sinopharm vaccine 3 (12%) manifested AstraZeneca vaccine. Six (24%) new-onset lichen planus (LP) 1 (4%) patient LP flare-up. Two (8%) psoriasis case showed exacerbation. One pemphigus vulgaris (PV) experienced a flare PV lesions. pityriasis lichenoides et varioliformis acuta (PLEVA) Other as follows: toxic epidermal necrolysis (TEN) (n = 1, 4%), bullous pemphigoid (BP) 2, 8%), alopecia areata (AA) pytriasis rosea herpes zoster small vessel vasculitis erythema multiform (EM) urticaria 3, 12%), morphea 4%). Physicians should be aware side especially vaccines.

Language: Английский

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Cutaneous adverse reactions of COVID ‐19 vaccines: A systematic review

Dermatologic Therapy, Journal Year: 2022, Volume and Issue: 35(5)

Published: Feb. 23, 2022

Numerous vaccines are under clinical development and implementation for the prevention of severe course lethal outcomes coronavirus disease 2019 (COVID-19). This systematic review aims to summarize integrated findings studies regarding cutaneous side effects COVID-19 vaccines. conducted by searching scientific databases PubMed, Scopus, Science direct, Web knowledge from beginning May 10, 2021. Articles were reviewed analyzed based on Preferred Reporting Items Systematic Reviews Meta-Analyses checklist. Seventeen included after screening search results eligibility criteria. The showed that most common injection site reactions delayed large local reactions, arising all vaccine types, redness/erythema (39%), followed by: itchiness (28%), urticarial rash (17%) neck, upper limbs, trunk, morbilliform eruptions (6.5%), Pityriasis rosea (3%), swelling, burning, so forth. Most occurred in women (84%), middle-aged people, first dose vaccine, with onset ranged 1 21 days vaccination. In addition, generally self-limiting, needed little or no therapeutic intervention, not regarded as a barrier injecting second dose. conclusion, very rare approved have satisfactory safety profiles. Therefore, mild moderate should discourage people certain groups such patients allergies history pre-vaccination counseling assurance, also use appropriate medications may be helpful. However, more investigate effect profile

Language: Английский

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Delayed systemic urticarial reactions following mRNA COVID-19 vaccination

Allergy and Asthma Proceedings, Journal Year: 2022, Volume and Issue: 43(1), P. 40 - 43

Published: Jan. 1, 2022

Background: As the vaccination campaign in response to coronavirus disease 2019 (COVID-19) pandemic continues, concerns with regard adverse reactions vaccine remain. Although immediate hypersensitivity have received much attention, delayed systemic urticarial after can occur. Objective: To describe clinical presentation, excipient skin testing results, and outcomes of subsequent COVID-19 patients who experienced messenger RNA (mRNA) vaccination. Methods: This was a retrospective case series 12 referred Mayo Clinics Rochester, Minnesota, Jacksonville, Florida, between January 19, 2021, April 30, for evaluation mRNA Demographics, medical allergic history, reaction details, results (when performed), outcome were collected each patient. Results: The mean age 52 years, all white, 9 (75%) women. Half had history drug allergy, one chronic spontaneous urticaria. Seven reacted Pfizer-BioNTech five Moderna vaccine. developed symptoms 8 24 hours Nine required antihistamines treatment. median time symptom resolution 4 days. underwent allergist-directed testing, which negative. Ten chose receive their next dose, four recurrent Conclusion: Delayed not life-threatening, could be treated antihistamines, predicted testing. They contraindication vaccination, although should counseled possibility recurrence.

Language: Английский

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Generalized pustular psoriasis flare in a patient affected by plaque psoriasis after BNT162b2 mRNA COVID‐19 vaccine, successfully treated with risankizumab

Journal of the European Academy of Dermatology and Venereology, Journal Year: 2022, Volume and Issue: 36(7)

Published: Feb. 28, 2022

With the widespread use of COVID-19 vaccines, several cutaneous adverse reactions are emerging, including flares pre-existing dermatoses1, 2: we describe case a 47-year-old female patient, affected by plaque psoriasis since 2001, who presented to our Emergency Department with an exacerbation after second dose BNT162b2 vaccine. The patient referred rapid worsening her psoriasis, starting from 10 days vaccination (Second inoculated on 23 May 2021). She was treatment ustekinumab 90 mg 2016, and she skipped scheduled administration in 2021. also obesity psoriatic arthritis; previously treated infliximab, discontinued for intolerance. On physical examination, observed wide erythematous plaques confluent both trunk four limbs, covered large scales. PASI 29.8 involved body surface more than 30% total area. had fever (38.2 °C) arthralgias; blood examinations showed 11 000/mm3 white cells, C-reactive protein 14.56 mg/dL. After hospitalization, cultures at febrile peak returned negative; 2 later, numerous small pustules surrounding scaling plaques, although pustular eruption particularly intense folds. clinical appearance suggestive flare generalized (GPP) superimposed supposed relationship shot During became larger, coalescent thicker, involving patient's palms soles; few patches began ulcerate scaly face scalp (Figs. 1 2a,b). Tumour markers malignancy were negative. Having considered risk infection, comorbidities severity therefore decided start therapy risankizumab 75 mg/fl two subcutaneous injections, while oral daptomycin 850 mg/day prescribed. One week first risankizumab, disappeared weeks hospitalization improved, only slight erythema. received date is still therapy, having achieved complete disease control (PASI 0) Week 16 (Fig. 2c). Flare-up setting SARS-CoV2 infection3 vaccines widely described literature, usually resolving but, sometimes, needing rescue therapies.4-6 D. Pesqué et al. suggested relevant role re-activation inflammatory pathways underlying psoriasis.7 B. Awada hypothesized that (or infection) may lead IFN-I-mediated immune response stimulating plasmacitoid dendritic cells. It has been Sars-CoV-2 infection as trigger IFN-driven disorder such GPP genetically susceptible individuals.8 Perna reported vaccine, acitretin.9 Regarding prescribed IL-23 inhibitor, intolerant optimal ustekinumab, severe infections. In conclusion, vaccine: this could probably be rare reaction related interrupted biological therapy. Since high rate patients, should strongly recommended population. other hand, dermatologists keep mind possibility flare-up dermatoses or onset new manifestations predisposed patients. No guidelines currently available concerning management further cases collected deepen knowledge. manuscript gave written informed consent publication details. A. Narcisi served advisory boards, honoraria lectures research grants Almirall, Abbvie, Leo Pharma, Celgene, Eli Lilly, Janssen, Novartis, Sanofi-Genzyme, Amgen Boehringer Ingelheim. Costanzo consultant and/or speaker AbbVie, Amgen, Galderma, Boehringer, Pfizer, Sandoz UCB; R.G. Borroni Almirall Abbvie. None. Additional data request corresponding author.

Language: Английский

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Treatment of Moderate to Severe Psoriasis during the COVID-19 Pandemic: Lessons Learned and Opportunities

Journal of Clinical Medicine, Journal Year: 2022, Volume and Issue: 11(9), P. 2422 - 2422

Published: April 26, 2022

Since the beginning of coronavirus disease 2019 (COVID-19) pandemic, clinicians have been overwhelmed by questions beyond SARS-CoV-2 infection itself. In dermatology practice, facing difficulties concerning therapeutic management chronic immune-mediated skin disease, above all psoriasis. Major challenges arisen were to understand role immunosuppression or immunomodulation on COVID-19 evolution, benefit/risk ratio related discontinuation modification ongoing treatment, and appropriateness initiating new treatments, optimization timing in vaccination administration patients under immunomodulatory finally how find strategy patients’ through remote assistance. this comprehensive review, we present current evidence about course psoriasis during pandemic. The general message from dermatologists was that data did not suggest having PSO its treatment significantly increased risk more severe course, is highly recommended psoriatic patients, telehealth experience a success overall.

Language: Английский

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