1
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Fu S, Song X. The clinical and immunological features of alopecia areata following SARS-CoV-2 infection or COVID-19 vaccines. Expert Opin Ther Targets 2024; 28:273-282. [PMID: 38646688 DOI: 10.1080/14728222.2024.2344696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/15/2024] [Indexed: 04/23/2024]
Abstract
INTRODUCTION Alopecia areata (AA) is an autoimmune disease induced by viral infection or vaccination. With the increased incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the incidence of AA has also increased. Recently the incidence was found to be 7.8% from a previously reported rate of 2.1%. The physical and psychological damage caused by AA could seriously affect patients' lives, while AA is a challenging dermatological disease owing to its complex pathogenesis. AREAS COVERED This paper presents a comprehensive review of the prevalence, pathogenesis and potential therapeutic targets for AA after infection with SARS-CoV-2 or SARS-CoV-2 vaccine. EXPERT OPINION The treatment of AA remains challenging because of the complexity of its pathogenesis. For patients with AA after SARS-CoV-2 infection or vaccination, the use of sex hormones and alternative regenerative therapies may be actively considered in addition to conventional treatments. For preexisting disease, therapeutic agents should be adjusted to the patient's specific condition.
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Affiliation(s)
- Shiqi Fu
- The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Zhejiang, China
| | - Xiuzu Song
- Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Hangzhou, China
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2
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Chen J, Cano-Besquet S, Ghantarchyan H, Neeki MM. The Incidence of Alopecia Areata in a COVID-19-Vaccinated Population: A Single-Center Review. Cureus 2023; 15:e50133. [PMID: 38186412 PMCID: PMC10771325 DOI: 10.7759/cureus.50133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
Background Cases of alopecia areata (AA) attributed to the coronavirus disease 2019 (COVID-19) vaccination have been reported in recent literature. However, these reports are reflective of specific geographic areas, and whether this phenomenon is observed in other regions remains to be investigated. This study focused on the association between AA and COVID-19 vaccination among patients from a large single-center safety net hospital in California. Methodology In this study, using electronic health records of patients and publicly available vaccination data, the demographics of patients including age group, sex, and race along with the vaccination status were carefully reviewed. Results A total of 73 cases of AA in the period from the release of the COVID-19 vaccination on December 17, 2020, to February 10, 2023, were identified. The odds ratios (ORs) for developing AA among the vaccinated and unvaccinated for each demographic level were calculated. Among all vaccinated individuals, the OR for developing AA was 0.58 (95% confidence interval (CI) = 0.35-0.94, p-value = 0.02). Conclusions This investigation noted no apparent increase in the incidence of AA among the vaccinated population compared to the unvaccinated population.
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Affiliation(s)
- Jeff Chen
- Internal Medicine, California University of Science and Medicine, Colton, USA
| | | | | | - Michael M Neeki
- Emergency Medicine, Arrowhead Regional Medical Center, Colton, USA
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3
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Wang CW, Wu MY, Chen CB, Lin WC, Wu J, Lu CW, Chen WT, Wang FY, Hui RCY, Chi MH, Chiu TM, Chang YC, Lin JY, Lin YYW, Tsai WT, Hung SI, Chung WH. Clinical characteristics and immune profiles of patients with immune-mediated alopecia associated with COVID-19 vaccinations. Clin Immunol 2023; 255:109737. [PMID: 37586672 DOI: 10.1016/j.clim.2023.109737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/14/2023] [Accepted: 08/11/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND The clinical characteristics and pathomechanism for immune-mediated alopecia following COVID-19 vaccinations are not clearly characterized. OBJECTIVE We investigated the causality and immune mechanism of COVID-19 vaccines-related alopecia areata (AA). STUDY DESIGN 27 new-onset of AA patients after COVID-19 vaccinations and 106 vaccines-tolerant individuals were enrolled from multiple medical centers for analysis. RESULTS The antinuclear antibody, total IgE, granulysin, and PARC/CCL18 as well as peripheral eosinophil count were significantly elevated in the patients with COVID-19 vaccines-related AA compared with those in the tolerant individuals (P = 2.03 × 10-5-0.039). In vitro lymphocyte activation test revealed that granulysin, granzyme B, and IFN-γ released from the T cells of COVID-19 vaccines-related AA patients could be significantly increased by COVID-19 vaccine excipients (polyethylene glycol 2000 and polysorbate 80) or spike protein (P = 0.002-0.04). CONCLUSIONS Spike protein and excipients of COVID-19 vaccines could trigger T cell-mediated cytotoxicity, which contributes to the pathogenesis of immune-mediated alopecia associated with COVID-19 vaccines.
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Affiliation(s)
- Chuang-Wei Wang
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China
| | - Ming-Ying Wu
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Bing Chen
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Wei-Chen Lin
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jennifer Wu
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chun-Wei Lu
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Ti Chen
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Fang-Ying Wang
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Biomedical Engineering, College of Medicine, College of Engineering, National Taiwan University, Taiwan
| | - Rosaline Chung-Yee Hui
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Min-Hui Chi
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Molecular Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tsu-Man Chiu
- Department of Dermatology, Chung Shan Medical University Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ya-Ching Chang
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jing Yi Lin
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yang Yu-Wei Lin
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan
| | - Wan-Ting Tsai
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan
| | - Shuen-Iu Hung
- Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou, Taiwan; Institute of Pharmacology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Wen-Hung Chung
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Tucheng and Keelung, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Department of Medical Research, Chang Gung Memorial Hospital, Linkou, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan; Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; Allergology Consortium, Xiamen Chang Gung Hospital, Xiamen, China; Department of Dermatology, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China; Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan.
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Iwata K, Kunisada M. Alopecia universalis after injection of messenger RNA COVID-19 vaccine. A case report. IDCases 2023; 33:e01830. [PMID: 37441583 PMCID: PMC10293118 DOI: 10.1016/j.idcr.2023.e01830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Messenger RNA vaccines against SARS-CoV-2 infection, or COVID-19 dramatically changed the landscape of the fight against COVID-19 pandemic. However, they might be associated with various side effects, such as myocarditis. Herein we report a case of alopecia universalis occurring after injection of an mRNA COVID-19 vaccine in a Japanese patient. Healthcare workers should be aware of this rather rare complication after vaccinations.
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Affiliation(s)
- Kentaro Iwata
- Division of Infectious Diseases, Kobe University Hospital, 7-5-2 Kusunokicho, Chuoku, Kobe, Japan
| | - Makoto Kunisada
- Department of Dermatology, Kobe University Hospital, 7-5-2 Kusunokicho, Chuoku, Kobe, Japan
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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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Genco L, Cantelli M, Noto M, Battista T, Patrì A, Fabbrocini G, Vastarella M. Alopecia Areata after COVID-19 Vaccines. Skin Appendage Disord 2023; 9:141-143. [PMID: 36926281 PMCID: PMC9892995 DOI: 10.1159/000528719] [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: 08/07/2022] [Accepted: 12/13/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction Alopecia areata (AA) is a common autoimmune disease characterized by non-scarring hair loss. New onsets of AA have been associated with coronavirus disease 2019 (COVID-19). Various skin diseases have already been reported because of the vaccines (the Pfizer-BioNTech COVID-19 vaccine, the Moderna COVID-19 vaccine, the AstraZeneca vaccine) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Case Presentation We report 5 cases of AA after COVID-19 vaccination. The trend shown by patients in this study is an initial worsening after the first dose of the vaccine with the stability of the disease even with subsequent doses. However, it is worth highlighting the case reported by one of our patients who suffered a "booster effect" of the disease with progressive and worsening alopecia with each vaccine booster. Discussion The possible mechanism of action lies in the ability of COVID-19 vaccines to induce spike protein, which can lead to molecular mimicry phenomena. In an organism predisposed to autoimmunity, the mRNA vaccine acts as a trigger. Furthermore, we would like to point out how even cytokine storm and simple oxidative stress from SARS-CoV-2 infection can induce not only AA but also other types of hair loss such as telogen effluvium. Thus, this highlights how complex and multifaceted the phenomenon is.
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Affiliation(s)
- Lucia Genco
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Cantelli
- 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
| | - Teresa Battista
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Angela Patrì
- 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
| | - Maria Vastarella
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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7
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Hernández Arroyo J, Izquierdo-Condoy JS, Ortiz-Prado E. A Case Series and Literature Review of Telogen Effluvium and Alopecia Universalis after the Administration of a Heterologous COVID-19 Vaccine Scheme. Vaccines (Basel) 2023; 11:vaccines11020444. [PMID: 36851320 PMCID: PMC9968192 DOI: 10.3390/vaccines11020444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 01/29/2023] [Accepted: 02/03/2023] [Indexed: 02/17/2023] Open
Abstract
COVID-19 vaccines have positively changed the course of the pandemic. They entered the market after only one year of the initial trials, which that yielded positive results in terms of safety and efficacy. However, after inoculating billions of people in the most extensive vaccination campaign worldwide, mild but common and some rare but potentially fatal adverse events have been reported. Among several self-reported adverse events, hair loss and alopecia have been linked to COVID-19 mRNA or viral vector vaccines. We tracked and followed a series of five cases with post-vaccine telogen effluvium and alopecia development in Ecuador. Here, we reported the clinical presentation of two women and three men with the diagnosis of post-vaccine hair loss. All patients received a heterologous vaccination scheme (mRNA and attenuated virus vaccine) with an additional viral vector booster associated with the apparition of telogen effluvium and alopecia universalis between 3 and 17 days after the vaccine was administered.
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Affiliation(s)
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito 170137, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito 170137, Ecuador
- Correspondence: ; Tel.: +593-995760693
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Osman S, Traboulsi D. Hydroxychloroquine for granuloma annulare: A case report on secondary hair growth in alopecia universalis. SAGE Open Med Case Rep 2023; 11:2050313X231152066. [PMID: 36744055 PMCID: PMC9893069 DOI: 10.1177/2050313x231152066] [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] [Indexed: 01/29/2023] Open
Abstract
Alopecia areata is an autoimmune disease resulting in non-scarring hair loss. Alopecia areata can progress to become alopecia totalis (loss of hair from the entire scalp) or alopecia universalis (loss of hair form the entire body), with the progression estimated to range from 7% to 30%. There are no universally proven therapies that both induce and sustain remission, and furthermore, the course of alopecia areata tends to be unpredictable, with ~80% of patients achieving spontaneous remission within 1 year. We herein present the case of a 61-year-old female who presented with a 20-year history of alopecia universalis, and biopsy confirmed widespread granuloma annulare. Hydroxychloroquine was initiated to treat her granuloma annulare, with subsequent significant hair regrowth on her scalp, eyebrows, eyelashes, and arms. A review of the literature is presented showing that hydroxychloroquine has variable success in treatment of alopecia areata, alopecia totalis, and alopecia universalis.
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Affiliation(s)
- Selena Osman
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Selena Osman, Suite 305, 8500 Blackfoot Trail SE, Calgary, AB T2J 7E1, Canada.
| | - Danya Traboulsi
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, AB, Canada
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Matsuda Y, Kawakami Y, Kawamoto M, Hirai Y, Morizane S. A case of extensive alopecia areata following Pfizer‐BioNTech BNT162b2 mRNA COVID‐19 vaccine with favorable outcome. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2023. [DOI: 10.1002/cia2.12292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Yoshihiro Matsuda
- Department of Dermatology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Yoshio Kawakami
- Department of Dermatology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Masaya Kawamoto
- Department of Dermatology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Yoji Hirai
- Department of Dermatology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Shin Morizane
- Department of Dermatology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
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10
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Desai AD, Falotico JM, McMahon DE, Freeman EE, French LE, Lipner SR. Hair and nail reactions represent a small proportion of all COVID-19 dermatologic reactions in an analysis of an international COVID-19 dermatological registry. Int J Dermatol 2022:10.1111/ijd.16499. [PMID: 36371710 PMCID: PMC9877566 DOI: 10.1111/ijd.16499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/14/2022]
Affiliation(s)
| | | | - Devon E. McMahon
- Department of Dermatology, Massachusetts General HospitalHarvard Medical SchoolBostonMAUSA
| | - Esther E. Freeman
- Department of Dermatology, Massachusetts General HospitalHarvard Medical SchoolBostonMAUSA,Medical Practice Evaluation Center, Mongan InstituteMassachusetts General HospitalBostonMAUSA
| | - Lars E. French
- Department of Dermatology, University HospitalMunich University of Ludwig MaximilianMunichGermany
| | - Shari R. Lipner
- Weill Cornell MedicineDepartment of DermatologyNew YorkNYUSA
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11
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MIYAWAKI K, KOMORI T, ISHIDA Y, SAKAGUCHI Y, HONJO H, KUDO M, OTSUKA A. Cronkhite-Canada Syndrome Mimicking COVID-19-related Symptoms. Acta Derm Venereol 2022; 102:adv00812. [PMID: 36250761 PMCID: PMC9811305 DOI: 10.2340/actadv.v102.3402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Kayo MIYAWAKI
- Department of Dermatology, Kindai University Faculty of Medicine, 377-2 OhnoHigashi, Osaka-Sayama, Osaka
| | - Takaya KOMORI
- Department of Dermatology, Kindai University Faculty of Medicine, 377-2 OhnoHigashi, Osaka-Sayama, Osaka
| | - Yoshihiro ISHIDA
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuri SAKAGUCHI
- Department of Dermatology, Kindai University Faculty of Medicine, 377-2 OhnoHigashi, Osaka-Sayama, Osaka
| | - Hajime HONJO
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 OhnoHigashi, Osaka-Sayama, Osaka
| | - Masatoshi KUDO
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 OhnoHigashi, Osaka-Sayama, Osaka
| | - Atsushi OTSUKA
- Department of Dermatology, Kindai University Faculty of Medicine, 377-2 OhnoHigashi, Osaka-Sayama, Osaka
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12
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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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13
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Singh R, Freeman EE. Viruses, Variants, and Vaccines: How COVID-19 Has Changed the Way We Look at Skin. CURRENT DERMATOLOGY REPORTS 2022; 11:289-312. [PMID: 36274754 PMCID: PMC9574791 DOI: 10.1007/s13671-022-00370-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Rhea Singh
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St, Boston, MA 02114 USA
- Virginia Commonwealth University School of Medicine, Richmond, VA USA
| | - Esther E. Freeman
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St, Boston, MA 02114 USA
- Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA USA
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14
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Tassone F, Cappilli S, Antonelli F, Zingarelli R, Chiricozzi A, Peris K. Alopecia Areata Occurring after COVID-19 Vaccination: A Single-Center, Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10091467. [PMID: 36146545 PMCID: PMC9505739 DOI: 10.3390/vaccines10091467] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 12/03/2022] Open
Abstract
Limited data concerning the development of autoimmune skin diseases after COVID-19 vaccination are currently available. Recently, a few reports described the development, worsening or recurrence of alopecia areata after the administration of COVID-19 vaccines. High variability in terms of disease onset following vaccination as well as the heterogeneous topical and/or systemic treatment approaches have been described. Methods: All patient-related data and images were obtained as part of clinical routine. Diagnosis of alopecia areata was established according to clinical and trichoscopic findings, along with the exclusion of common differential diagnoses. Results. Twenty-four patients, 20 females (83.3%) and four males (16.7%), with a mean age of 39.1 years (age range: 14–66 years), were examined for the occurrence of alopecia areata within 16 weeks after COVID-19 vaccination. Out of 24, 14 patients (58.3%) experienced a patchy alopecia areata, while an extensive disease occurred in 10/24 patients (41.7%): six patients with whole scalp involvement (alopecia areata totalis) and four patients with the whole body affected (alopecia areata universalis). Twelve patients reported a history of autoimmune disease (50%). Treatment with topical corticosteroid was performed in almost all patients with patchy alopecia areata, whilst it was associated with systemic drugs (corticosteroids, minoxidil, cyclosporin) in the case of generalized alopecia areata and alopecia areata universalis. Mean baseline values of Severity of Alopecia Tool (SALT) score decreased from 43.4 to 36.6 after 12 weeks of treatment, with evidence of hair regrowth in 16/21 patients. Conclusion. This study described the occurrence of alopecia areata after COVID-19 vaccination and its management that implicates the use of both topical and systemic therapies.
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Affiliation(s)
- Francesco Tassone
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Simone Cappilli
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Flaminia Antonelli
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ruggiero Zingarelli
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Andrea Chiricozzi
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Largo A. Gemelli 8, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-06-30154227; Fax: +39-06-30154919
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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15
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Abdalla H, Ebrahim E. Alopecia Areata Universalis Precipitated by SARS-CoV-2 Vaccine: A Case Report and Narrative Review. Cureus 2022; 14:e27953. [PMID: 35975094 PMCID: PMC9375056 DOI: 10.7759/cureus.27953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2022] [Indexed: 11/25/2022] Open
Abstract
Alopecia areata (AA) is a patchy autoimmune nonscarring hair loss. Various pathophysiological explanations are described with immune dysregulation being the most well established. In this report, we describe a 63-year-old lady with AA recurrence, in the form of AA universalis, after 32 years of remission, following administration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. We also briefly reviewed published cases with similar presentations after receiving the SARS-CoV-2 vaccine.
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16
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Cebeci Kahraman F, Savaş Erdoğan S, Aktaş ND, Albayrak H, Türkmen D, Borlu M, Arıca DA, Demirbaş A, Akbayrak A, Polat Ekinci A, Gökçek GE, Çelik HA, Taşolar MK, An İ, Temiz SA, Hazinedar E, Ayhan E, Hızlı P, Solak EÖ, Kılıç A, Yılmaz E. Cutaneous reactions after COVID-19 vaccination in Turkey: A multicenter study. J Cosmet Dermatol 2022; 21:3692-3703. [PMID: 35780311 PMCID: PMC9349975 DOI: 10.1111/jocd.15209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/21/2022] [Accepted: 06/30/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES In this study covering all of Turkey, we aimed to define cutaneous and systemic adverse reactions in our patient population after COVID-19 vaccination with the Sinovac/CoronaVac (inactivated SARS-CoV-2) and Pfizer/BioNTech (BNT162b2) vaccines. METHODS This prospective, cross-sectional study included individuals presenting to the dermatology or emergency outpatient clinics of a total of 19 centers after having been vaccinated with the COVID-19 vaccines. Systemic, local injection site, and non-local cutaneous reactions after vaccination were identified, and their rates were determined. RESULTS Of the 2290 individuals vaccinated between April 15 and July 15, 2021, 2097 (91.6%) received the CoronaVac vaccine and 183 (8%) BioNTech. Systemic reactions were observed at a rate of 31.0% after the first CoronaVac dose, 31.1% after the second CoronaVac dose, 46.4% after the first BioNTech dose, and 46.2% after the second BioNTech dose. Local injection site reactions were detected at a rate of 35.6% after the first CoronaVac dose, 35.7% after the second CoronaVac dose, 86.9% after the first BioNTech dose, and 94.1% after the second BioNTech dose. A total of 133 non-local cutaneous reactions were identified after the CoronaVac vaccine (2.9% after the first dose and 3.5% after the second dose), with the most common being urticaria/angioedema, pityriasis rosea, herpes zoster, and maculopapular rash. After BioNTech, 39 non-local cutaneous reactions were observed to have developed (24.8% after the first dose and 5% after the second dose), and the most common were herpes zoster, delayed large local reaction, pityriasis rosea, and urticaria/angioedema in order of frequency. Existing autoimmune diseases were triggered in 2.1% of the patients vaccinated with CoronaVac and 8.2% of those vaccinated with BioNTech. CONCLUSIONS There are no comprehensive data on cutaneous adverse reactions specific to the CoronaVac vaccine. We determined the frequency of adverse reactions from the dermatologist's point of view after CoronaVac and BioNTech vaccination and identified a wide spectrum of non-local cutaneous reactions. Our data show that CoronaVac is associated with less harmful reactions while BioNTech may result in more serious reactions, such as herpes zoster, anaphylaxis, and triggering of autoimmunity. However, most of these reactions were self-limiting or required little therapeutic intervention.
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Affiliation(s)
- Filiz Cebeci Kahraman
- Department of Dermatologyİstanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City HospitalİstanbulTurkey
| | - Sevil Savaş Erdoğan
- Department of DermatologyUniversity of Health Sciences, İstanbul Training and Research HospitalİstanbulTurkey
| | - Nurhan Döner Aktaş
- Department of Dermatologyİzmir Katip Çelebi University, Atatürk Training and Research HospitalİzmirTurkey
| | - Hülya Albayrak
- Department of Dermatology, Faculty of MedicineNamık Kemal UniversityTekirdağTurkey
| | - Dursun Türkmen
- Department of Dermatology, Faculty of Medicineİnönü UniversityMalatyaTurkey
| | - Murat Borlu
- Department of Dermatology, Faculty of MedicineErciyes UniversityKayseriTurkey
| | - Deniz Aksu Arıca
- Department of Dermatology, Faculty of MedicineKaradeniz Technical UniversityTrabzonTurkey
| | - Abdullah Demirbaş
- Department of Dermatology, Faculty of MedicineKocaeli UniversityKocaeliTurkey
| | - Atiye Akbayrak
- Department of Dermatology, Faculty of MedicineGaziosmanpaşa UniversityTokatTurkey
| | - Algün Polat Ekinci
- Department of Dermatology, İstanbul Faculty of Medicineİstanbul UniversityİstanbulTurkey
| | - Gözde Emel Gökçek
- Department of Dermatology, Faculty of MedicineYozgat Bozok UniversityYozgatTurkey
| | - Hilal Ayvaz Çelik
- Department of Dermatology, Faculty of MedicineIsparta Süleyman Demirel UniversityIspartaTurkey
| | | | - İsa An
- Department of DermatologyŞanlıurfa Training and Research HospitalŞanlıurfaTurkey
| | - Selami Aykut Temiz
- Department of DermatologyNecmettin Erbakan University Meram Faculty of MedicineKonyaTurkey
| | - Emel Hazinedar
- Department of Dermatology, Faculty of MedicineZonguldak Bülent Ecevit UniversityZonguldakTurkey
| | - Erhan Ayhan
- Department of DermatologyUniversity of Health Sciences, Gazi Yaşargil Training and Research HospitalDiyarbakırTurkey
| | - Pelin Hızlı
- Department of Dermatology, Faculty of MedicineBalıkesir UniversityBalıkesirTurkey
| | - Eda Öksüm Solak
- Department of Dermatology, Faculty of MedicineErciyes UniversityKayseriTurkey
| | - Arzu Kılıç
- Department of Dermatology, Faculty of MedicineBalıkesir UniversityBalıkesirTurkey
| | - Ertan Yılmaz
- Department of Dermatology, Faculty of MedicineAkdeniz UniversityAntayaTurkey
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17
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Gamonal SBL, Marques NCV, Pereira HMB, Gamonal ACC. New-onset Systemic Lupus Erythematosus after ChAdOX1 nCoV-19 and Alopecia Areata after BNT162b2 vaccination against SARS-CoV-2. Dermatol Ther 2022; 35:e15677. [PMID: 35770484 PMCID: PMC9350344 DOI: 10.1111/dth.15677] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/04/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Shirley Braga Lima Gamonal
- Department of Dermatology, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
| | | | | | - Aloisio Carlos Couri Gamonal
- Department of Dermatology, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
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18
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Birkett L, Singh P, Mosahebi A, Dhar S. Possible Associations Between Alopecia Areata and COVID-19 Vaccination and Infection. Aesthet Surg J 2022; 42:NP699-NP702. [PMID: 35724419 PMCID: PMC9384321 DOI: 10.1093/asj/sjac165] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Liam Birkett
- Corresponding Author: Dr Liam Birkett, Department of Plastic Surgery, Royal Free Hospital, Pond Street, London NW3 2QG, UK. E-mail:
| | - Prateush Singh
- Department of Plastic Surgery, Royal Free Hospital, London, UK
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