1
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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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2
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Joshi TP, Duvic M. Pityriasis Rubra Pilaris: An Updated Review of Clinical Presentation, Etiopathogenesis, and Treatment Options. Am J Clin Dermatol 2024; 25:243-259. [PMID: 38159213 DOI: 10.1007/s40257-023-00836-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
Pityriasis rubra pilaris (PRP) is a rare papulosquamous reaction pattern with a significant impact on quality of life. Type I PRP is the most common PRP variant, presenting as erythematous papules emerging in a follicular distribution and later coalescing into plaques with characteristic islands of sparing; histologically, an alternating pattern of orthokeratosis and parakeratosis is considered the hallmark of PRP (checkerboard hyperkeratosis). Other PRP variants (types II-V) differ in their age of onset and clinical presentation. Type VI PRP is a rare PRP subtype associated with human immunodeficiency virus infection and is occasionally associated with diseases of the follicular occlusion tetrad. Caspase recruitment domain family, member 14 (CARD14)-associated papulosquamous eruption and facial discoid dermatitis are newly described disease states that have an important clinical overlap with PRP, creating shared conundrums with respect to diagnosis and treatment. The etiology inciting PRP often remains uncertain; PRP has been suggested to be associated with infection, malignancy, or drug/vaccine administration in some cases, although these are based on case reports and causality has not been established. Type V PRP is often due to inborn CARD14 mutations. Furthermore, recent literature has identified interleukin-23/T-helper-17 cell axis dysregulation to be a major mediator of PRP pathogenesis, paving the way for mechanism-directed therapy. At present, high-dose isotretinoin, ixekizumab, and secukinumab are systemic agents supported by single-arm prospective studies; numerous other agents have also been trialed for PRP, with variable success rates. Here, we discuss updates on clinical manifestations, present new insights into etiopathogenesis, and offer a survey of recently described therapeutic options.
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Affiliation(s)
- Tejas P Joshi
- School of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
| | - Madeleine Duvic
- Department of Dermatology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
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3
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Liu YA, Dai J, Nagarajan P, Torres-Cabala CA, Aung PP, Prieto VG, Cho WC. Pityriasis Rubra Pilaris After Moderna COVID-19 Vaccination: A Case Report and Literature Review. Am J Dermatopathol 2023; 45:185-188. [PMID: 36626570 DOI: 10.1097/dad.0000000000002369] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/18/2022] [Indexed: 01/12/2023]
Abstract
ABSTRACT To date, over 60% of the world's population has received at least 1 dose of coronavirus disease 2019 (COVID-19) vaccination, with over 12 billion doses administered globally. Commonly reported adverse effects of COVID-19 vaccination include fever, headache, myalgia, and injection site reactions. The spectrum of documented cutaneous reactions after COVID-19 vaccination is broad; however, pityriasis rubra pilaris (PRP) or PRP-like eruption secondary to COVID-19 vaccine is exceedingly rare, with only 17 cases previously reported to date in the English literature. In this article, we describe an additional case of COVID-19 vaccination-associated PRP in a 50-year-old woman with a history of metastatic breast carcinoma, who developed a widespread cutaneous eruption characteristic of PRP, including palmoplantar keratoderma, 10 days after her third dose of Moderna COVID-19 vaccine. Punch biopsy specimen showed epidermal hyperplasia with overlying hyperkeratosis, alternating orthokeratosis and parakeratosis and focal follicular plugging, supporting the diagnosis of PRP. The patient improved within weeks of initiating oral acitretin and topical steroids, with resolution achieved after 3 months of continued therapy. To the best of our knowledge, this is the third reported case of Moderna COVID-19 vaccination-associated PRP and collectively the 18 th after the administration of all COVID-19 vaccines currently available, including Pfizer-BioNTech, and AstraZeneca.
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Affiliation(s)
| | - Julia Dai
- Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Carlos A Torres-Cabala
- Departments of Pathology, and
- Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Victor G Prieto
- Departments of Pathology, and
- Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX
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4
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Potestio L, Genco L, Noto M, Fabbrocini G, Battista T, Martora F. Comment on 'Pityriasis rubra pilaris-like eruption following mRNA COVID-19 vaccine'. Clin Exp Dermatol 2023; 48:44-45. [PMID: 36669180 DOI: 10.1093/ced/llac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/13/2022] [Indexed: 01/21/2023]
Affiliation(s)
- Luca Potestio
- 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
| | - Matteo Noto
- 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
| | - Teresa Battista
- 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
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5
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Ponatinib-Associated Cutaneous Eruptions-A Case Series and Review of Clinicopathologic Findings. Am J Dermatopathol 2023; 45:64-68. [PMID: 36484611 DOI: 10.1097/dad.0000000000002344] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/08/2022] [Indexed: 12/13/2022]
Abstract
ABSTRACT Ponatinib is a third-generation tyrosine kinase inhibitor used to treat chronic myeloid leukemia and Philadelphia-positive acute lymphoblastic leukemia. Cutaneous toxicities are a commonly reported side effect of ponatinib treatment with "rash" being one of the most common. Specific subtypes are infrequently reported, but include hyperkeratotic, folliculocentric, ichthyosiform, and pityriasis rubra pilaris-like eruptions. Herein, we highlight the clinicopathologic features of 2 cases of ponatinib-induced pityriasis rubra pilaris-like eruptions. We also classify the clinical and histopathologic features of all previously reported ponatinib-associated eruptions in the literature and discuss treatment and potential diagnostic pitfalls.
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6
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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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7
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Gamonal SBL, Marques NCV, Pereira HMB, Gamonal ACC. Pityriasis rubra pilaris (type I) following administration of the BNT162b2 mRNA COVID-19 vaccine: Successful treatment with ustekinumab and acitretin. Dermatol Ther 2022; 35:e15899. [PMID: 36196603 PMCID: PMC9874643 DOI: 10.1111/dth.15899] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/04/2022] [Accepted: 10/01/2022] [Indexed: 01/28/2023]
Affiliation(s)
- Shirley Braga Lima Gamonal
- Department of Dermatology, Faculty of MedicineFederal University of Juiz de Fora (UFJF)Juiz de ForaBrazil
| | | | - Heitor Motta Bini Pereira
- Department of DermatologySchool of Medical Sciences and Health of Juiz de Fora (FCMS/JF)Juiz de ForaBrazil
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8
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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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9
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Hlaca N, Zagar T, Kastelan M, Peternel S, Brajac I, Dujmovic-Hasanbegovic K, Prpic-Massari L. Pityriasis rubra pilaris following booster dose of mRNA (Pfizer-BioNTech) COVID-19 vaccine. Dermatol Ther 2022; 35:e15791. [PMID: 36029037 PMCID: PMC9538535 DOI: 10.1111/dth.15791] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/27/2022] [Accepted: 08/24/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Nika Hlaca
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Tina Zagar
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Marija Kastelan
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Sandra Peternel
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Ines Brajac
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Katarina Dujmovic-Hasanbegovic
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Larisa Prpic-Massari
- Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
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10
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Liu Y, Wang S. Ixekizumab successfully treated severe pityriasis rubra pilaris after COVID-19 vaccination. SKIN HEALTH AND DISEASE 2022; 3:e139. [PMID: 35941937 PMCID: PMC9349810 DOI: 10.1002/ski2.139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 11/13/2022]
Abstract
Pityriasis rubra pilaris is an inflammatory dermatologic disorder of unknown cause. We report a 67-year-old man with Pityriasis rubra pilaris might induced by COVID-19 vaccination. The patient developed the lesions after the first dose of vaccine and significantly aggravated after the second dose. He had poor effect and liver function impairment developed after acitretin used, but achieved satisfactory efficacy after replacement to ixekizumab, an interleukin-17A inhibitor.
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Affiliation(s)
- Ya‐ting Liu
- Department of DermatologyHuashan HospitalFudan UniversityShanghaiChina
| | - Shang‐shang Wang
- Department of DermatologyHuashan HospitalFudan UniversityShanghaiChina
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11
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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: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [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 January 1, 2019, to December 31, 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 pre-counseling 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 Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Triwatcharikorn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Phannajit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - M Ullman
- Department of Research Affairs, Chulalongkorn University, Bangkok, Thailand
| | - P Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - P Rerknimitr
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
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12
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Gambichler T, Scheel CH, Arafat Y, Kautz O, Boms S. Erythrodermic pityriasis rubra pilaris after SASRS-CoV-2 vaccination with concomitant COVID-19 infection. J Eur Acad Dermatol Venereol 2022; 36:e675-e676. [PMID: 35536694 PMCID: PMC9347623 DOI: 10.1111/jdv.18214] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C H Scheel
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Y Arafat
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
| | - O Kautz
- NordWestHisto, Westerstede, Germany
| | - S Boms
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
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13
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Wada M, Lee S, Curnow P, Simpson I, Mar A. A case of Pityriasis rubra pilaris following AstraZeneca COVID-19 vaccine. JAAD Case Rep 2022; 24:74-77. [PMID: 35529074 PMCID: PMC9059431 DOI: 10.1016/j.jdcr.2022.04.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Miki Wada
- Department of Dermatology, Monash Health, Clayton, Victoria, Australia
- Correspondence to: Miki Wada, BMedSc, MD, Department of Dermatology, Monash Medical Centre, 246 Clayton Road, Clayton, VIC 3168, Australia.
| | - Senhong Lee
- Department of Dermatology, Monash Health, Clayton, Victoria, Australia
| | - Paul Curnow
- Department of Dermatology, Monash Health, Clayton, Victoria, Australia
| | - Ian Simpson
- Department of Pathology, Monash Health, Clayton, Victoria, Australia
| | - Adrian Mar
- Department of Dermatology, Monash Health, Clayton, Victoria, Australia
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14
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Bramhoff AC, Wesselmann U, Bender ST, Berghoff AV, Hofmann SC, Balakirski G. [Pityriasis rubra pilaris after COVID-19 vaccination: causal relationship or coincidence?]. Hautarzt 2022; 73:634-637. [PMID: 35296923 PMCID: PMC8926091 DOI: 10.1007/s00105-022-04972-z] [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] [Accepted: 02/14/2022] [Indexed: 12/03/2022]
Abstract
Seit der Markteinführung der COVID-19-Impfstoffe werden regelmäßig kutane Nebenwirkungen dieser Vakzine beschrieben. Diese beinhalten unter anderem lokale Impfreaktionen (insbesondere den sog. COVID-Arm), urtikarielle, makulopapulöse und pityriasiforme Exantheme oder vorübergehende Exazerbationen einer vorbestehenden chronisch entzündlichen Hauterkrankung. Wir berichten über 3 Fälle einer Pityriasis rubra pilaris, die in engem zeitlichen Zusammenhang mit der Verabreichung eines COVID-19-Impfstoffs erstmals aufgetreten sind.
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Affiliation(s)
- A C Bramhoff
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland
| | - U Wesselmann
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland
| | - S T Bender
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland
| | - A V Berghoff
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland
| | - S C Hofmann
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland
| | - G Balakirski
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland.
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15
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Fernández LT, Pérez-Garza DM, O-Escamilla ADL, Yamallel-Ortega LA, Cuellar-Barboza A, Ocampo-Candiani J, Chavez-Alvarez S. Pityriasis rubra pilaris in association with inactivated SARS-CoV-2 vaccine (CoronaVac). Dermatol Ther 2022; 35:e15455. [PMID: 35297142 PMCID: PMC9111812 DOI: 10.1111/dth.15455] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/12/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Lucía T Fernández
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Dermatology Department, Monterrey, Nuevo León, México
| | - Daniela M Pérez-Garza
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Dermatology Department, Monterrey, Nuevo León, México
| | - Alejandra de la O-Escamilla
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Dermatology Department, Monterrey, Nuevo León, México
| | - Luis A Yamallel-Ortega
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Dermatology Department, Monterrey, Nuevo León, México
| | - Adrian Cuellar-Barboza
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Dermatology Department, Monterrey, Nuevo León, México
| | - Jorge Ocampo-Candiani
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Dermatology Department, Monterrey, Nuevo León, México
| | - Sonia Chavez-Alvarez
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Dermatology Department, Monterrey, Nuevo León, México
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Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review. Microorganisms 2022; 10:microorganisms10030624. [PMID: 35336199 PMCID: PMC8953728 DOI: 10.3390/microorganisms10030624] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/07/2022] [Accepted: 03/09/2022] [Indexed: 02/07/2023] Open
Abstract
Because of the increasing emergence of cutaneous reactions from COVID-19 vaccines worldwide, we investigated the published reports of these complications. We searched the PubMed, Google Scholar, and Scopus databases and the preprint server bioRxiv for articles on cutaneous complications linked to mRNA-1273 (Moderna), BNT162b2 (Pfizer–BioNTech), and AZD1222 (AstraZeneca–Oxford University) vaccines published until 30 September 2021. Eighty studies describing a total of 1415 reactions were included. Cutaneous reactions were more prevalent in females (81.6%). Delayed large local reactions were the most common complication (40.4%), followed by local injection site reactions (16.5%), zoster (9.5%), and urticarial eruptions (9.0%). Injection site and delayed large local reactions were predominantly caused by the mRNA-1273 vaccine (79.5% and 72.0%, respectively). BNT162b2 vaccination was more closely linked to distant reactions (50.1%) than mRNA-1273 (30.0%). Zoster was the most common distant reaction. Of reactions with adequate information for both vaccine doses, 58.3% occurred after the first dose only, 26.9% after the second dose only, and 14.8% after both doses. Overall, a large spectrum of cutaneous reaction patterns occurred following the COVID-19 vaccination. Most were mild and without long-term health implications. Therefore, the occurrence of such dermatologic complications does not contraindicate subsequent vaccination.
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Criado P, Ianhez M, Rocha P, Miot H. Pityriasis rubra pilaris (type I) following ChAdOx1 COVID‐19 vaccine: report of two cases with successful treatment with oral isotretinoin. J Eur Acad Dermatol Venereol 2022; 36:e508-e510. [PMID: 35278239 PMCID: PMC9114897 DOI: 10.1111/jdv.18055] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/02/2022] [Accepted: 03/04/2022] [Indexed: 11/28/2022]
Affiliation(s)
- P.R. Criado
- Centro Universitário Faculdade de Medicina do ABC and Alergoskin Alergia e Dermatologia Santo André SP Brazil
| | - M. Ianhez
- Universidade Federal de Goiás (UFG) and Cório Clínica de Dermatologia Goiânia GO Brazil
- Hospital de Doenças Tropicais Goiânia GO Brazil
| | - P.S. Rocha
- Hospital de Doenças Tropicais Goiânia GO Brazil
| | - H.A. Miot
- UNESP Medical School Botucatu SP Brazil
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18
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Mungmunpuntipantip R, Wiwanitkit V. Response to "Pityriasis rubra pilaris-like eruption following mRNA COVID-19 vaccine". Clin Exp Dermatol 2022; 47:1195-1196. [PMID: 35187721 PMCID: PMC9111552 DOI: 10.1111/ced.15150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/27/2022]
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Avallone G, Quaglino P, Cavallo F, Roccuzzo G, Ribero S, Zalaudek I, Conforti C. SARS-CoV-2 vaccine-related cutaneous manifestations: a systematic review. Int J Dermatol 2022; 61:1187-1204. [PMID: 35141881 PMCID: PMC9111829 DOI: 10.1111/ijd.16063] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 12/10/2021] [Accepted: 12/30/2021] [Indexed: 12/14/2022]
Abstract
To date, over 250 million people have been reportedly infected by COVID‐19 disease, which has spread across the globe and led to approximately 5.1 million fatalities. To prevent both COVID‐19 and viral transmission, DNA‐based/RNA‐based vaccines, non‐replicating viral vector vaccines, and inactivated vaccines have been recently developed. However, a precise clinical and histological characterization of SARS‐CoV‐2 vaccine‐related dermatological manifestations is still lacking. A systematic review of 229 articles was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, in order to provide an extensive overview of SARS‐CoV‐2 vaccine‐related skin manifestations. Data on demographics, number of reported cases with cutaneous involvement, vaccine, and rash type (morphology) were extracted from articles and summarized. A total of 5941 SARS‐CoV‐2 vaccine‐related dermatological manifestations were gathered. Local injection‐site reactions were the most frequently observed, followed by rash/unspecified cutaneous eruption, urticarial rashes, angioedema, herpes zoster, morbilliform/maculopapular/erythematous macular eruption, pityriasis rosea and pityriasis rosea‐like eruptions, and other less common dermatological manifestations. Flares of pre‐existing dermatological conditions were also reported. Cutaneous adverse reactions following SARS‐CoV‐2 vaccine administration seem to be heterogeneous, rather infrequent, and not life‐threatening. Vaccinated patients should be monitored for skin manifestations, and dermatological evaluation should be offered, when needed.
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Affiliation(s)
- Gianluca Avallone
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Francesco Cavallo
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Gabriele Roccuzzo
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
| | - Claudio Conforti
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
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20
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Cutaneous Adverse Reactions Associated with SARS-CoV-2 Vaccines. J Clin Med 2021; 10:jcm10225344. [PMID: 34830627 PMCID: PMC8618511 DOI: 10.3390/jcm10225344] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 12/19/2022] Open
Abstract
Many patients are receiving SARS-CoV-2 vaccinations, which have been associated with a variety of adverse effects. Cutaneous adverse reactions to SARS-CoV-2 vaccinations have been progressively reported, but they have not been reviewed according to their morphological clinical patterns. The objective of this review was to summarize the existing data concerning the cutaneous adverse reactions following SARS-CoV-2 vaccines and group them according to common morphological and pathogenetic patterns. We reviewed the English language literature up to 15 August 2021, using predefined keywords to identify the relevant studies evaluating cutaneous adverse reactions associated with SARS-CoV-2 vaccines. We search for recurrent morphological patterns sharing clinical signs and symptoms and physio-pathological mechanisms. Timing to onset following the first or booster dose of the vaccine, predisposing conditions, therapeutic management, and outcome were also collected. Among the dermatological manifestations associated with SARS-CoV-2 vaccinations, we distinguished: (1) new onset reactions and (2) flares of preexisting dermatoses. The most common were injection site reactions, affecting 30–70% and generally mild or moderate. Small case series or single case reports included filler reactions, exanthemas, vascular lesions, urticaria, eczematous dermatitis, autoimmune bullous reactions, and severe cutaneous adverse reactions. In addition, the exacerbation of chronic immuno-mediated dermatoses (mainly psoriasis and atopic dermatitis) and reactivations of herpes infection were reported. The cutaneous reactions were generally mild, self-limiting, and resembled common cutaneous drug eruptions and/or COVID-19 skin manifestations.
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