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Martora F, Megna M, Battista T, Scalvenzi M, Villani A, Cacciapuoti S, Potestio L. Viral reactivation following COVID-19 vaccination: a review of the current literature. Clin Exp Dermatol 2024; 49:556-565. [PMID: 38374769 DOI: 10.1093/ced/llae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/02/2024] [Accepted: 02/10/2024] [Indexed: 02/21/2024]
Abstract
Currently, four vaccines for COVID-19 have been licensed by the European Medicines Agency: two viral vector-based vaccines and two mRNA-based vaccines. Since their approval, several cutaneous reactions related to vaccination have been reported in the literature. Among these, viral reactivations are one of the most frequent. The aim of this article was to investigate the current literature regarding viral reactivations following COVID-19 vaccination, focusing attention on pityriasis rosea (PR), herpes zoster and herpes simplex. A comprehensive literature search using various databases was performed and we included metanalyses, reviews, letters to the editor, real-life studies, case series and reports. A total of 48 articles involving 2067 patients were selected. Of these, 32, 6 and 17 articles reported varicella zoster virus (VZV) reactivation (1758 patients), herpes simplex virus (HSV) (238 patients) onset and PR (71 patients), respectively (some articles discussed more than one of these three reactivations). Possible pathogenetic mechanisms underlying viral reactivation are still not understood. Also, the possible correlations between vaccination and viral reactivation should be clarified. Certainly, vaccination should not be discouraged.
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Affiliation(s)
- Fabrizio Martora
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Napoli, Italy
| | - Matteo Megna
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Napoli, Italy
| | - Teresa Battista
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Napoli, Italy
| | - Massimiliano Scalvenzi
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Napoli, Italy
| | - Alessia Villani
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Napoli, Italy
| | - Sara Cacciapuoti
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Napoli, Italy
| | - Luca Potestio
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Napoli, Italy
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Duzett L, Mercado G, Tasouli-Drakou V, Kane A, Tam A. Pityriasis following COVID-19 vaccinations: a systematic review. Dermatol Reports 2024; 16:9742. [PMID: 38623364 PMCID: PMC11017724 DOI: 10.4081/dr.2023.9742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/01/2023] [Indexed: 04/17/2024] Open
Abstract
In the wake of a global COVID-19 pandemic, where innovations in vaccination technology and the speed of development and distribution have been unprecedented, a wide variety of post-vaccination cutaneous reactions have surfaced. However, there has not been a systematic review that investigates pityriasis eruptions and the associated variants following COVID-19 inoculations. A PubMed search using Preferred Reporting Items for Systematic Reviews and Meta-Analyses was performed to find case reports from the earliest record through November 2022. Data including types of vaccination and pityriasis were extracted and a quality review was performed; 47 reports with 94 patients were found: 64.9% had pityriasis rosea (PR), 3.2% PR-like eruptions, 16.0% pityriasis rubra pilaris, 7.4% pityriasis lichenoides et varioliformis acuta, 3.2% pityriasis lichenoides chronica, and 5.3% had reactions described as atypical. The top three COVID-19 vaccinations reported were Pfizer-BioNTech (47.9%), Oxford-AstraZeneca (11.7%), and Moderna (8.5%). Pityriasis reactivity was reported most frequently after the Pfizer-BioNTech vaccination, with pityriasis rosea being the most common variant. A large difference was additionally found between the ratio of post-vaccination pityriasis reactions following Pfizer and Moderna vaccinations (5.63), and the ratio of Pfizer's usage in the United States as of December 28, 2022 relative to that of Moderna (1.59). Further studies with adequate follow-up periods and diagnostic testing will thus need to be performed to elucidate the root of this discrepancy and better characterize the association between different pityriasis reactions and COVID-19 vaccinations.
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Affiliation(s)
- Laura Duzett
- Department of Clinical Education, College of Osteopathic Medicine, Touro University Nevada, Henderson, NV
| | - Guadalupe Mercado
- Department of Clinical Education, College of Osteopathic Medicine, Touro University Nevada, Henderson, NV
| | - Vasiliki Tasouli-Drakou
- Department of Clinical Education, College of Osteopathic Medicine, Touro University Nevada, Henderson, NV
| | - Alicia Kane
- Department of Clinical Education, College of Osteopathic Medicine, Touro University Nevada, Henderson, NV
| | - Alison Tam
- Plastic Surgery Vegas, Las Vegas, NV, USA
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Potestio L, Martora F, Cacciapuoti S, Megna M, Villani A, Ruggiero A. Pityriasis Rosea and Pityriasis Rosea-Like Eruption Following COVID-19 Vaccination: A Narrative Review. Clin Cosmet Investig Dermatol 2024; 17:51-57. [PMID: 38222859 PMCID: PMC10785683 DOI: 10.2147/ccid.s447834] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/04/2024] [Indexed: 01/16/2024]
Abstract
COVID-19 pandemic completely changed every aspect of human life. Several measures were adopted to limit the spreading of the infection. Among these, vaccination was the main one. Globally, vaccination campaign was a success, showing to be efficient in controlling and preventing the SARS-Cov2 infection, reducing the risk of disease progression, hospitalization, and mortality. However, with the increasing number of vaccines administered, several cutaneous reactions were described, making dermatologists key players in their recognition and treatment. Among these, also viral reactivations have been described. In particular, cases of Pityriasis Rosea (PR) and PR-like reactivations have been collected. An early diagnosis is mandatory to avoid mistreatments. In this context, we conducted a review of the current literature investigating cases of PR following COVID-19 vaccination with the aim of understanding the possible pathogenetic mechanisms and causal correlation as well as to investigate the risk of this cutaneous eruption, to offer clinicians a wide perspective on the linkage between PR and COVID-19 vaccines.
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Affiliation(s)
- Luca Potestio
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Fabrizio Martora
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Sara Cacciapuoti
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Alessia Villani
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Angelo Ruggiero
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Bin Rubaian NF, Aljalfan AA, Almuhaidib SR. Management of coronavirus disease 2019 vaccine-induced cutaneous complications: A comprehensive literature review. J Family Community Med 2023; 30:161-170. [PMID: 37675215 PMCID: PMC10479027 DOI: 10.4103/jfcm.jfcm_3_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/12/2023] [Accepted: 05/29/2023] [Indexed: 09/08/2023] Open
Abstract
Despite the numerous reports of cutaneous manifestations associated with vaccines for coronavirus disease 2019 (COVID-19), the relationship between COVID-19 vaccines and cutaneous side effects remains unevaluated. In this review, we examine these manifestations and their management. Reported dermatoses included injection-site reaction (early and delayed), type I allergic reaction, morbilliform eruption, pityriasis rosea, Sweet syndrome, lichen planus, psoriasis, herpes zoster reactivation, erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis (TEN). The most common COVID-19 vaccination-related cutaneous manifestations are delayed local reactions, approximately 66% of which are associated with the Moderna vaccine, and 33% with the Pfizer vaccine. Aside from mild injection-site reactions, severe reactions include anaphylaxis and TEN. Most reactions, except for Stevens-Johnson syndrome and anaphylaxis, though unpredictable and unpreventable are mild and can be treated symptomatically. Findings from this review should allow primary care physicians and dermatologists to reach faster diagnosis and initiate prompt intervention.
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Affiliation(s)
- Nouf F. Bin Rubaian
- Department of Dermatology, King Fahad University Hospital, Al-Khobar, Saudi Arabia
| | - Abdullah A. Aljalfan
- Department of Dermatology, King Fahad University Hospital, Al-Khobar, Saudi Arabia
| | - Serene R. Almuhaidib
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Martora F, Battista T, Ruggiero A, Scalvenzi M, Villani A, Megna M, Potestio L. The Impact of COVID-19 Vaccination on Inflammatory Skin Disorders and Other Cutaneous Diseases: A Review of the Published Literature. Viruses 2023; 15:1423. [PMID: 37515110 PMCID: PMC10384785 DOI: 10.3390/v15071423] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
Background: Four vaccines have been authorized by the European Medicines Agency (EMA): viral vector-based vaccines (AstraZeneca; AZD1222 and Johnson & Johnson; Ad26.COV2. and 2 mRNA-based vaccines (Pfizer/BioNTech; BNT162b2 and Moderna; mRNA-1273). Adverse events (AEs) related to vaccination have been described in the literature. The main aim of the dermatological practice was to avoid the diffusion of COVID-19, allowing the continuity of care for patients. Objective: The aim of this review article is to investigate current literature regarding cutaneous reactions following COVID-19 vaccination, mainly inflammatory dermatological diseases. Materials and methods: Investigated manuscripts included metanalyses, reviews, letters to the editor, real-life studies, case series, and reports. Results: We selected a total of 234 articles involving more than 550 patients. We have divided the results section into various sub-sections to ensure greater understanding for readers. Conclusions: Clinicians should keep in mind the possibility of new onsets or the worsening of several dermatoses following vaccination in order to promptly recognize and treat these AEs. Certainly, vaccination should not be discouraged.
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Affiliation(s)
- Fabrizio Martora
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Teresa Battista
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Angelo Ruggiero
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Massimiliano Scalvenzi
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Alessia Villani
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Matteo Megna
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Luca Potestio
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
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Wong N, Cascardo CA, Mansour M, Qian V, Potts GA. A Review of Pityriasis Rosea in Relation to SARS-CoV-2/COVID-19 Infection and Vaccination. Cureus 2023; 15:e38772. [PMID: 37303403 PMCID: PMC10250113 DOI: 10.7759/cureus.38772] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Pityriasis rosea (PR) is an acute exanthematous disease, commonly preceded by a primary solitary herald patch followed by the onset of smaller scaly papulosquamous lesions within days to weeks. The exact cause of PR remains unclear; however, rash eruptions are thought to be associated with systemic reactivation of human herpesvirus 6 and 7 (HHV-6/7). Several cutaneous manifestations, including PR, have been reported secondary to SARS-CoV-2 infection and/or COVID-19 vaccination. The purpose of this review is to synthesize available data regarding PR in close association with SARS-CoV-2/COVID-19 infection and/or vaccination. A total of 154 patients were included in this study with 62 females and 50 males. PR was reported to occur more commonly in association with SARS-CoV-2/COVID-19 vaccination (102, 66.2%) than during infection (22, 42.3%) or post-infection (30, 57.7%). Interestingly, only 7.1% of patients were tested for concomitant HHV-6/7 past or current infection, with 4.2% testing positive or reporting a history of roseola infantum. While rare, clinicians should be aware of the possibility of patients developing PR associated with SARS-CoV-2/COVID-19 infection and/or vaccination, among other cutaneous reactions. Future studies exploring the link between PR and SARS-CoV-2/COVID-19 infection and/or vaccination would be beneficial, including direct examination of tissue and serological studies for evidence of COVID-19-induced HHV-6/7 reactivation.
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Affiliation(s)
- Nikita Wong
- Dermatology, Wayne State University School of Medicine, Detroit, USA
| | - Camilla A Cascardo
- Medicine, Oakland University William Beaumont School of Medicine, Rochester, USA
| | - Meghan Mansour
- Medicine, Oakland University William Beaumont School of Medicine, Rochester, USA
| | - Victoria Qian
- Dermatology, Wayne State University School of Medicine, Detroit, USA
| | - Geoffrey A Potts
- Dermatology, Wayne State University School of Medicine, Detroit, USA
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Purushottam M, Rangappa V, Betkerur JB, Kombettu AP, Shastry V. Cutaneous Adverse Drug Reactions (CADRs) to COVID19 Vaccines: A Case Series. Indian Dermatol Online J 2023; 14:383-387. [PMID: 37266107 PMCID: PMC10231698 DOI: 10.4103/idoj.idoj_109_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 06/03/2023] Open
Abstract
Viral vector vaccines (Covishield) and inactivated vaccines (Covaxin) are now being administered worldwide to reduce the impact of life-threatening corona virus disease 19 (COVID-19). Various cutaneous adverse drug reactions (CADRs) have been reported following COVID-19 vaccination. Here, we are reporting series of CADRs following COVID-19 vaccination. Among 18 CADRs, 4 each were of acute urticaria and pityriasis rosea, 2 each of leukocytoclastic vasculitis and herpes zoster, 3 exacerbation of psoriasis, and 1 each of exacerbation of eczema, reactivation of herpes simplex virus 1 infection, and COVID arm. However, in 1 case there was remission of psoriasis. These CADRs occurred between 6 hours and 20 days after vaccination and were mild to moderate in severity. Only 1 needed hospitalization. Of the 18 CADRs, 10 developed after first dose and 8 after second dose. Causality assessment was done using World Health Organization causality assessment classification. Mass COVID-19 vaccination program is in progress worldwide. Many CADRs like COVID arm, urticaria, pityriasis rosea, leukocytoclastic vasculitis, herpes zoster etc., have been reported following vaccination. In our series only 1 developed cutaneous adverse drug reaction (CADR) to Covaxin. It was Covishield that was administered during the vaccination drive; hence, more cases were seen to that vaccine. Most of the CADRs were mild to moderate in intensity. Awareness of these adverse effects enables the healthcare professionals to be better equipped to recognize and manage them correctly.
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Affiliation(s)
- Manila Purushottam
- Department of Dermatology and Venereology, JSS Medical College, JSS Academy of Higher Education and Research Centre, Mysore, Karnataka, India
| | - Vinutha Rangappa
- Department of Dermatology and Venereology, JSS Medical College, JSS Academy of Higher Education and Research Centre, Mysore, Karnataka, India
| | - Jayadev B. Betkerur
- Department of Dermatology and Venereology, JSS Medical College, JSS Academy of Higher Education and Research Centre, Mysore, Karnataka, India
| | - Ashwini P. Kombettu
- Department of Dermatology and Venereology, JSS Medical College, JSS Academy of Higher Education and Research Centre, Mysore, Karnataka, India
| | - Veeranna Shastry
- Department of Dermatology and Venereology, JSS Medical College, JSS Academy of Higher Education and Research Centre, Mysore, Karnataka, India
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Martora F, Fabbrocini G, Megna M, Scalvenzi M, Battista T, Villani A, Potestio L. Teledermatology for Common Inflammatory Skin Conditions: The Medicine of the Future? Life (Basel) 2023; 13:life13041037. [PMID: 37109566 PMCID: PMC10146182 DOI: 10.3390/life13041037] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/09/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic period revolutionized daily clinical practice. Several strategies were adopted by clinicians to avoid reducing treatment for diseases without the risk of spreading the infection. Among the adopted strategies, telemedicine played a key role. In this scenario, several tools were used, including e-mails, phone calls, video calls, support groups, and messages. Fortunately, the COVID-19 pandemic period seems to be at an end. However, the use of teledermatology appears to be an excellent strategy for the future as well. Indeed, several patients may benefit from teledermatology. OBJECTIVE In this manuscript, we aim to investigate the use of telemedicine in the dermatological field to point out how this tool may become the mainstay of future medicine. Only the use of teledermatology with common inflammatory skin conditions have been reported herein. MATERIALS AND METHODS Investigated manuscripts included metanalyses, reviews, letters to the editor, real-life studies, case series, and reports. Manuscripts were identified, screened, and extracted for relevant data following the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. RESULTS A total of 121 records were identified from the analyzed databases. However, only 110 articles were assessed for eligibility. Finally, 92 articles were selected at the end of the literature research for our review. CONCLUSIONS Teledermatology should be considered as a viable option for the dermatologist for the future. We believe that the pandemic has strengthened this service, and this will allow for ever better development in the future. Guidelines regarding the use of teledermatology are required as well as additional improvements for the future.
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Affiliation(s)
- Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Massimiliano Scalvenzi
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Teresa Battista
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Alessia Villani
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
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Khan I, Elsanousi AA, Shareef AM, Tebha SS, Arif A, Gul S. Manifestation of pityriasis rosea and pityriasis rosea-like eruptions after Covid-19 vaccine: A systematic review. Immun Inflamm Dis 2023; 11:e804. [PMID: 37102660 PMCID: PMC10091373 DOI: 10.1002/iid3.804] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/18/2023] [Accepted: 02/24/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND After introducing Covid-19 vaccines, a few side effects were reported, pityriasis rosea being one of them. Therefore, this study will systematically review its manifestation afteradministration. METHODS Databases were searched, covering a timeline from December 1, 2019 to February 28, 2022. Data were independently extracted and accessed for bias. SPSS statistical software version 25 was used for appropriate inferential statistics. RESULTS Thirty-one studies were included for data extraction after screening following the eligibility criteria. A total of 111 people were identified to have developed pityriasis rosea or pityriasis rosea-like eruptions after vaccination, out of which 36 (55.38%) were female. The average age of incidence was calculated to be 44.92 years, and 63 (62.37%) people presented after administration of the first dose. It was found popularly in the trunk area, either asymptomatically or with mild symptoms. Meantime the onset, was 8.58 days, and meantime it took to recover, was 6.44 weeks. CONCLUSION The association between pityriasis rosea and pityriasis rosea-like eruptions after Covid-19 vaccines was established, but given the scarcity of studies, there is a need to conduct different clinical trials to confirm this association further and study the etiology and mechanism of the disease.
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Affiliation(s)
- Iman Khan
- Department of MedicineZiauddin Medical UniversityKarachiSindhPakistan
| | - Ahmed A. Elsanousi
- Department of MedicineUniversity of Medical Science and TechnologyKhartoumSudan
| | - Amena M. Shareef
- Department of MedicineDeccan College of Medical SciencesHyderabadIndia
| | - Sameer S. Tebha
- Department of Neurosurgery and NeurologyJinnah Medical and Dental CollegeKarachiSindhPakistan
| | - Aabiya Arif
- Department of MedicineZiauddin Medical UniversityKarachiSindhPakistan
| | - Sana Gul
- Department of DermatologyJinnah Medical and Dental CollegeKarachiSindhPakistan
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A Systematic Review of Histopathologic Surveys on Mucocutaneous Biopsies in Patients Developed COVID-19 Vaccine-Related Dermatologic Manifestations. Am J Dermatopathol 2023; 45:1-27. [PMID: 36484603 DOI: 10.1097/dad.0000000000002320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ABSTRACT Coronavirus 2 is an infectious agent primarily identified as the cause of a pandemic viral pneumonia. With the mass vaccination against this virus, one of the health issues is the safety of currently available vaccines considering their adverse reactions. This systematic review was conducted to assess and summarize all reported data on histopathologic findings associated with mucocutaneous reactions that developed after COVID-19 vaccination for a better pathophysiology interpretation and clinical management of these reactions. A systematic search was performed in PubMed, Web of Science, and Scopus databases as well as Google Scholar engine for relevant English articles published till July 1, 2022. This review includes 131 studies with a total number of 287 cases. Eruptions that underwent a biopsy were mostly described as erythematous maculopapular, papulosquamous, vasculitis-like, lichenoid, or urticarial lesions. Histopathology revealed spongiosis, interstitial, and perivascular lymphohistiocytic infiltration, erythrocyte extravasation, parakeratosis, endothelial inflammation, and the like. Findings were highly consistent with morbilliform erythema, psoriasiform dermatosis, leukocytoclastic vasculitis, and lichenoid or urticarial drug reactions. The majority of these reactions had a mild nature and were primarily observed in patients with underlying health conditions. Microscopic evaluation was also consistent with transient inflammatory changes, and features like neutrophilic infiltrates, subcorneal pustules, and vasculopathy were less frequently reported than what seen in COVID infection. Therefore, dermatologic reactions developing after vaccination in the general population should not hinder a complete vaccination.
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11
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Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature. Clin Cosmet Investig Dermatol 2022; 15:2369-2382. [PMID: 36387962 PMCID: PMC9648179 DOI: 10.2147/ccid.s388245] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/02/2022] [Indexed: 07/30/2023]
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) represented a new worldwide challenge, strongly impacting on the global economy, overall health and lifestyle. Since then, several strategies have been adopted to contain the widespread of infection. Among these, vaccination is currently the most important measure to fight against the pandemic. However, several concerns such as slower-than-hoped-for rollout, the hurried approval with limited data, the mechanism of action (in particular mRNA-based), and the uncertain duration of protection they afforded were initially raised. Moreover, even if cutaneous reactions have been rarely reported in clinical trials, global mass vaccination showed several dermatologic reactions not initially recognized, leaving dermatologists to decide how to diagnose and treat them. In this scenario, dermatologists should be ready to promptly recognize these clinical manifestations. Thus, the aim of this manuscript is to review current literature on cutaneous reactions following COVID-19 vaccination, particularly inflammatory dermatological diseases, in order to help clinicians to better understand these dermatological conditions and to provide an extensive overview of all the vaccine-related skin manifestations.
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Affiliation(s)
- Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Teresa Battista
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Lucia Genco
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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12
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Washrawirul C, Triwatcharikorn J, Phannajit J, Ullman M, Susantitaphong P, Rerknimitr P. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2022; 36:1947-1968. [PMID: 35666609 PMCID: PMC9348179 DOI: 10.1111/jdv.18294] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/18/2022] [Indexed: 01/08/2023]
Abstract
Although vaccination is widely accepted as an effective method of preventing and controlling the COVID-19 pandemic, many people are concerned about possible cutaneous side-effects, which can delay or prevent them from being vaccinated. The objectives of this systematic review were to assess the global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination. PubMed and Scopus databases were searched for articles published from 1 January 2019 to 31 December 2021, and reference lists for each selected article were screened. Case reports, case series, observational studies and randomized controlled trials that provided information on cutaneous adverse reactions following COVID-19 vaccines were included. A total of 300 studies were included in a systematic review of which 32 studies with 946 366 participants were included in the meta-analysis. The pooled prevalence of cutaneous manifestations following COVID-19 vaccination was 3.8% (95% CI, 2.7%-5.3%). COVID-19 vaccines based on the mRNA platform had a higher prevalence than other platforms at 6.9% (95% CI, 3.8%-12.3%). Various cutaneous manifestations have been reported from injection site reactions, which were the most common (72.16%) to uncommon adverse reactions such as delayed inflammatory reactions to tissue filler (0.07%) and flares of pre-existing dermatoses (0.07%). Severe cutaneous reactions such as anaphylaxis have also been reported, but in rare cases (0.05%). In conclusion, cutaneous adverse reactions are common, especially in those receiving mRNA vaccines. Most reactions are mild and are not contraindications to subsequent vaccination except for anaphylaxis, which rarely occurs. COVID-19 vaccination may also be associated with flares of pre-existing dermatoses and delayed inflammatory reactions to tissue filler. Patients with a history of allergies, pre-existing skin conditions or scheduled for filler injections should receive additional precounselling and monitoring. A better understanding of potential side-effects may strengthen public confidence in those wary of new vaccine technologies.
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Affiliation(s)
- C. Washrawirul
- Division of Dermatology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | - J. Triwatcharikorn
- Division of Dermatology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | - J. Phannajit
- Division of Nephrology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
- Division of Clinical Epidemiology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
- King Chulalongkorn Memorial HospitalThai Red Cross SocietyBangkokThailand
- Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | - M. Ullman
- Department of Research AffairsChulalongkorn UniversityBangkokThailand
| | - P. Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
- King Chulalongkorn Memorial HospitalThai Red Cross SocietyBangkokThailand
- Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | - P. Rerknimitr
- Division of Dermatology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
- Skin and Allergy Research UnitChulalongkorn UniversityBangkokThailand
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Salmi AA, Khamisani MA, Shibli AA, Maqbali SA. Adverse cutaneous reactions reported post COVID-19 vaccination in AL Buraimi Governorate, Sultanate of Oman. Dermatol Ther 2022; 35:e15820. [PMID: 36097882 PMCID: PMC9538483 DOI: 10.1111/dth.15820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/24/2022] [Accepted: 09/10/2022] [Indexed: 11/26/2022]
Abstract
On March 11, 2020, the World Health Organization (WHO) declared the novel coronavirus (COVID‐19) a global pandemic. This has led to the rapid development and emergency approval of vaccines to overcome the alarming spread of the virus. Data on the cutaneous side effects related to the COVID‐19 vaccine remains limited. In this prospective observational study, which was conducted from June 20 to September 20, 2021, we evaluated the incidence and various patterns of cutaneous side effects reported post COVID‐19 vaccination in Al Buraimi Governorate in Oman. All vaccinated individuals aged 12 years and older, who had a skin reaction within 4 weeks following any dose of the COVID‐19 vaccine, were enrolled in the study. The demographic data, medical history, vaccine‐related information of all the patients were documented and the analysis was performed using the SPSS version 23 software. In total, 67 cutaneous reactions were reported by 55 patients accounting for 0.11% of all vaccinated individuals. The mean age of the patients was 33.3 years, 80.6% were females, 61.2% of the reactions were reported after the first vaccine dose, and 38.8% were reported after the second dose. We observed a wide range of cutaneous reactions and categorized them into three major patterns: local injection site reaction (2%), new onset rash (81.6%), and flare up of pre‐existing dermatological conditions (16.4%). Notably, urticaria was the most common reaction overall, followed by generalized pruritus and maculopapular rash. In general, we reported a diversity of cutaneous side effects that healthcare workers should be aware of as some reactions may be overlooked and not linked to the COVID‐19 vaccination.
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14
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Cubital Tunnel Syndrome Temporally after COVID-19 Vaccination. Trop Med Infect Dis 2022; 7:tropicalmed7040062. [PMID: 35448837 PMCID: PMC9028216 DOI: 10.3390/tropicalmed7040062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/09/2022] [Accepted: 04/14/2022] [Indexed: 02/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is the most dramatic pandemic of the new millennium. To counter it, specific vaccines have been launched in record time under emergency use authorization or conditional marketing authorization and have been subjected to additional monitoring. The European Medicines Agency recommend reporting any suspected adverse reactions during this additional monitoring phase. For the first time in the available medical literature, we report a left cubital tunnel syndrome in a 28-year-old right-handed healthy male after seven days from the first dose of Spikevax® (formerly Moderna COVID-19 Vaccine). Histochemistry for Alcian Blue performed on the tissue harvested from the cubital site reveals myxoid degeneration of the small nerve collaterals, a clear sign of nerve injury. It still remains unclear why the syndrome occurs in a localized and not generalized form to all osteofibrous tunnels. Today, modified messenger ribonucleic acid vaccines as Spikevax® represent an avantgarde technological platform with a lot of potential, but one which needs careful monitoring in order to identify in advance those patients who may experience adverse events after their administration.
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AKYÖN ŞH, GENÇ Y. Pityriasis Rosea After Pfizer-BioNTech Covid-19 Vaccine: A Case Report. TURKISH JOURNAL OF INTERNAL MEDICINE 2022. [DOI: 10.46310/tjim.1072232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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16
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Drago F, Broccolo F, Ciccarese G. Comment on a case of pityriasis rosea shortly after Moderna COVID-19 vaccination. Int J Infect Dis 2022; 116:166. [PMID: 34990801 PMCID: PMC8720674 DOI: 10.1016/j.ijid.2021.12.360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/26/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Francesco Drago
- Dermatology Unit, Policlinico San Martino, Largo R. Benzi, 10, 16132 Genoa, Italy.
| | - Francesco Broccolo
- Department of Medicine and Surgery, School of Medicine, University of Milano-Bicocca, Monza, Italy
| | - Giulia Ciccarese
- Dermatology Unit, Policlinico San Martino, Largo R. Benzi, 10, 16132 Genoa, Italy
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mRNA-1273. REACTIONS WEEKLY 2022. [PMCID: PMC8758344 DOI: 10.1007/s40278-022-08887-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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18
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Alghubaywi F, Almukhadeb E, Alharthi Y, Alharbi A. Vaccine-induced pityriasis rosea and pityriasis rosea-like Eruptions: A review of literature and a case report of COVID-19 vaccine-induced pityriasis rosea. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2022. [DOI: 10.4103/jdds.jdds_7_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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