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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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2
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Wang F, Gao Y, Wagner AL, Lu Y. A systematic review and meta-analysis of herpes zoster occurrence/recurrence after COVID-19 infection and vaccination. J Med Virol 2024; 96:e29629. [PMID: 38682607 DOI: 10.1002/jmv.29629] [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: 12/07/2023] [Revised: 04/01/2024] [Accepted: 04/12/2024] [Indexed: 05/01/2024]
Abstract
To inform surveillance, prevention, and management strategies for the varicella zoster virus (VZV) during the COVID-19 pandemic, this study aimed to evaluate the risk of herpes zoster (HZ) occurrence/recurrence following COVID-19 infection and vaccination. A comprehensive search across seven databases was conducted up to January 31, 2024, to identify studies relevant to the occurrence of HZ following COVID-19 infection and vaccination. The meta-analysis included five studies on postinfection HZ and 13 studies on postvaccination HZ. Patients infected with COVID-19 had a 2.16-fold increased risk of HZ (95% confidence interval [CI]: 1.24-3.76) than uninfected individuals. However, there was no significant association between COVID-19 vaccination and the risk of HZ compared to controls, with a relative risk (RR) of 1.08 (95% CI: 0.84-1.39). Furthermore, a descriptive analysis of 74 postinfection and 153 postvaccination HZ studies found no significant differences on gender or age (<50 and ≥50 years) following COVID-19 infection. Notably, 44.0% of the HZ cases postinfection appeared within the first week, with 69.5% resolving within 10 days, predominantly presenting as skin lesions. In the postvaccination group, the majority (60.1%) developed HZ after the first dose and 66.7% occurred within 1 week. Moreover, 44.6% resolved within 10 days and 50.0% within a month, primarily exhibiting skin lesions and postherpetic neuralgia. The study found that COVID-19 infection increases the risk of HZ, but the COVID-19 vaccine does not. Further study is needed to explore the association between COVID-19 and HZ.
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Affiliation(s)
- Fengge Wang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
- Department of Epidemiology, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yidan Gao
- Department of Epidemiology, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Abram L Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Yihan Lu
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
- Department of Epidemiology, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
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3
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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: 0] [Impact Index Per Article: 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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4
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Viglizzo G, Herzum A, Gariazzo L, Olcese C, Occella C. Childhood vitiligo developing after COVID-19 infection. Dermatol Reports 2023; 15:9547. [PMID: 37753231 PMCID: PMC10518528 DOI: 10.4081/dr.2023.9547] [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: 06/17/2022] [Accepted: 07/10/2022] [Indexed: 09/28/2023] Open
Abstract
Both COVID-19 and vaccinations against it have been related to immune cutaneous manifestations. Here, we present a case of childhood vitiligo, developed after a COVID-19 infection.
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Affiliation(s)
| | - Astrid Herzum
- Dermatology Unit, Giannina Gaslini IRCCS Institute, Genoa
| | | | - Camilla Olcese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy
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Potestio L, Battista T, Cacciapuoti S, Ruggiero A, Martora F, Fornaro L, Camela E, Megna M. New Onset and Exacerbation of Psoriasis Following COVID-19 Vaccination: A Review of the Current Knowledge. Biomedicines 2023; 11:2191. [PMID: 37626687 PMCID: PMC10452075 DOI: 10.3390/biomedicines11082191] [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: 06/21/2023] [Revised: 07/19/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
COVID-19 vaccination was the main measure to overcome the pandemic. As with other drugs and vaccines, mild to moderate adverse events have been reported following vaccination. In addition, several cutaneous reactions have been described. In particular, there are several reports investigating de novo psoriasis or the exacerbation of psoriasis following COVID-19 vaccination. However, data on the possible pathogenetic mechanisms as well as comprehensive manuscripts on the topic are scant. Thus, the aim of our manuscript was to perform a review of the current literature on post-COVID-19 vaccination exacerbations and new-onset psoriasis in order to offer a wide perspective on this area and to point out possible pathogenetic mechanisms. Research on the current literature was performed following PRISMA guidelines. In total, 49 studies involving 134 patients developing new-onset psoriasis (n = 27, 20.1%) or psoriasis exacerbation (n = 107, 79.9%) were collected. Although cases of de novo psoriasis or a worsening of psoriasis have been reported following vaccination, all of the cases have been successfully treated while overall benefit-risk profile of COVID-19 vaccination does not justify vaccine hesitancy due to the risk of psoriasis being developed or worsening. Certainly, further studies are needed to identify possible pathogenetic mechanisms in order to identify "at-risk" patients. Finally, vaccination should not be discouraged.
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Affiliation(s)
- Luca Potestio
- 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
| | - Sara Cacciapuoti
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Luigi Fornaro
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Elisa Camela
- Dermatology Unit, Istituto Dermopatico dell’Immacolata—IRCCS, 00144 Rome, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
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Murata T, Nobukuni Y. Erythema Multiforme Induced by Zonisamide and Triggered by the First Dose of COVID-19 Vaccine (Pfizer-BioNTech). Am J Ther 2023; 30:e261-e265. [PMID: 37278706 DOI: 10.1097/mjt.0000000000001549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Tsukasa Murata
- Kumamoto Seimei Hospital, Kumamoto, Japan. Dr. Nobukuni is now with the Mashiki Hospital. Kamimashiki, Japan
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7
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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] [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 Medicine, Ziauddin Medical University, Karachi, Sindh, Pakistan
| | - Ahmed A Elsanousi
- Department of Medicine, University of Medical Science and Technology, Khartoum, Sudan
| | - Amena M Shareef
- Department of Medicine, Deccan College of Medical Sciences, Hyderabad, India
| | - Sameer S Tebha
- Department of Neurosurgery and Neurology, Jinnah Medical and Dental College, Karachi, Sindh, Pakistan
| | - Aabiya Arif
- Department of Medicine, Ziauddin Medical University, Karachi, Sindh, Pakistan
| | - Sana Gul
- Department of Dermatology, Jinnah Medical and Dental College, Karachi, Sindh, Pakistan
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Yousefian M, Khadivi A. Occurrence of erythema multiforme following COVID-19 vaccination: a review. Clin Exp Vaccine Res 2023; 12:87-96. [PMID: 37214146 PMCID: PMC10193109 DOI: 10.7774/cevr.2023.12.2.87] [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: 11/27/2022] [Accepted: 02/02/2023] [Indexed: 05/24/2023] Open
Abstract
The fast development of vaccines against the novel coronavirus disease is among the most critical steps taken to control this potentially fatal viral disease. Like other vaccines, the coronavirus disease 2019 (COVID-19) vaccines can also cause unwanted reactions. Erythema multiforme (EM) is among the oral mucocutaneous side effects of COVID-19 vaccines. This study aimed to comprehensively review the reported cases of EM since the global onset of COVID-19 vaccination. Data from 31 relevant studies regarding the type and dose of COVID-19 vaccines administered, time of initiation of symptoms, age, and gender of patients, site of involvement, patients' medical history, and treatment options were extracted. In total, 90 patients were identified with EM as a side effect of COVID-19 vaccination across studies. EM had the highest frequency after receiving the first dose of mRNA vaccines in older individuals. The first symptoms of EM appeared in less than 3 days in 45% and after 3 days in 55% of patients. EM is not a common side effect of COVID-19 vaccination, and fear of its occurrence should not impede vaccination.
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Affiliation(s)
- Marzieh Yousefian
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Alireza Khadivi
- School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
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9
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Burlando M, Herzum A, Cozzani E, Parodi A. Psoriasis flares after COVID-19 vaccination: adherence to biologic therapy reduces psoriasis exacerbations: a case-control study. Clin Exp Vaccine Res 2023; 12:80-81. [PMID: 36844681 PMCID: PMC9950225 DOI: 10.7774/cevr.2023.12.1.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 12/22/2022] [Indexed: 02/19/2023] Open
Abstract
This study aimed to evaluate if patients under biologics have a lower risk of psoriasis flares after coronavirus disease 2019 (COVID-19) vaccination than other psoriatic patients. Of 322 recently vaccinated patients admitted for psoriasis at the Dermatological Psoriasis Unit during January and February 2022, 316 (98%) had no psoriasis flares after COVID-19 vaccination (79% under biologic treatment, 21% not biologically treated) and 6 (2%) presented psoriasis flares after COVID-19 vaccination (33.3% under biologic treatment, 66.6% not biologically treated). Overall, psoriasis patients under biologic treatment, developed fewer psoriasis flares after COVID-19 vaccination (33.3%), than patients not under biologic treatment (66.6%) (p=0.0207; Fisher's exact test).
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Affiliation(s)
- Martina Burlando
- Section of Dermatology, Department of Health Sciences (DISSAL), San Martino Polyclinic Hospital IRCCS, University of Genoa, Genoa, Italy
| | - Astrid Herzum
- Section of Dermatology, Department of Health Sciences (DISSAL), San Martino Polyclinic Hospital IRCCS, University of Genoa, Genoa, Italy
| | - Emanuele Cozzani
- Section of Dermatology, Department of Health Sciences (DISSAL), San Martino Polyclinic Hospital IRCCS, University of Genoa, Genoa, Italy
| | - Aurora Parodi
- Section of Dermatology, Department of Health Sciences (DISSAL), San Martino Polyclinic Hospital IRCCS, University of Genoa, Genoa, Italy
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10
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Wu PC, Huang IH, Wang CW, Tsai CC, Chung WH, Chen CB. New Onset and Exacerbations of Psoriasis Following COVID-19 Vaccines: A Systematic Review. Am J Clin Dermatol 2022; 23:775-799. [PMID: 36048409 PMCID: PMC9434078 DOI: 10.1007/s40257-022-00721-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Vaccination has been promoted to control viral transmission in response to the coronavirus disease 2019 (COVID-19) pandemic. Cases of new-onset or exacerbation of psoriasis, an immune-mediated inflammatory disease, were reported following COVID-19 vaccination. However, a comprehensive review examining the association between COVID-19 vaccination and the occurrence or exacerbation of psoriasis has yet to be performed. OBJECTIVE The aim of this systematic review is to investigate the demographics, clinical variables, and outcomes associated with psoriasis following COVID-19 vaccination. METHODS A systematic literature search was conducted using the PubMed, Embase, Web of Science, and Cochrane databases from database inception to April 25, 2022. The review included studies with relevant terms, including 'psoriasis,' 'psoriasis vulgaris,' 'guttate psoriasis,' 'pustular psoriasis,' 'palmoplantar pustulosis,' 'psoriatic erythroderma,' 'psoriatic arthritis,' 'COVID-19,' and 'vaccine.' We included all studies reporting at least one patient who developed new-onset psoriasis or experienced a psoriasis flare following at least one dose of any COVID-19 vaccine. A flare was defined as the worsening of disease conditions after vaccination according to the study by Gregoire et al. The appraisal tool described by Murad et al. was used to assess the quality of case reports and series, whereas the National Institute of Health quality assessment tool was used to assess observational studies. RESULTS The initial search yielded 367 results, including 7 studies reporting new-onset psoriasis, 32 studies reporting psoriasis flares, and 4 studies reporting both. The most commonly observed psoriasis subtype was plaque-type psoriasis. mRNA vaccines, including those produced by Moderna and BioNTech/Pfizer, were frequently associated with subsequent psoriasis episodes. First, second, and third vaccine doses were associated with psoriasis incidents, with the second dose most frequently associated with psoriasis flares. Delayed onset was observed, ranging from 2 to 21 days in the new-onset group and from 1 to 90 days in the flare group. Most patients experienced favorable outcomes, with improvement or resolution occurring within 3 days to 4 months. CONCLUSIONS Both new-onset psoriasis and psoriasis flares were reported as cutaneous adverse events following COVID-19 vaccination. Psoriatic patients may require regular follow-up before and after COVID-19 vaccination. TRIAL REGISTRATION Review registration number PROSPERO database: CRD42022304157.
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Affiliation(s)
- Po-Chien Wu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan.,Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - I-Hsin Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan.,Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Chuang-Wei Wang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan.,Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan.,Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China.,College of Medicine, Chang Gung University, Linkou, Taoyuan, Taiwan
| | - Cheng-Chang Tsai
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan.,Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Wen-Hung Chung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan.,Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan.,Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China.,College of Medicine, Chang Gung University, Linkou, Taoyuan, Taiwan.,Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan.,Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,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, Taoyuan, Taiwan
| | - Chun-Bing Chen
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan. .,Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. .,Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. .,Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan. .,Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China. .,College of Medicine, Chang Gung University, Linkou, Taoyuan, Taiwan. .,Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan. .,Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. .,Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. .,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Linkou, Taoyuan, Taiwan. .,School of Medicine, National Tsing Hua University, Hsinchu, Taiwan.
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11
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Coexistence of Pemphigus Vulgaris and Lichen Planus following COVID-19 Vaccination. Case Rep Dermatol Med 2022; 2022:2324212. [PMID: 36072649 PMCID: PMC9441388 DOI: 10.1155/2022/2324212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/30/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022] Open
Abstract
SARS-CoV-2 vaccines were approved without long-term monitoring due to emergent situation and might have several side effects. Herein, we describe the first case with development of both LP and PV following COVID-19 vaccination. Immunological alteration due to COVID-19 vaccination and its potential role in triggering autoimmune disorders were also dealt with.
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12
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Shafie'ei M, Jamali M, Akbari Z, Sarvipour N, Ahmadzade M, Ahramiyanpour N. Cutaneous adverse reactions following COVID-19 vaccinations: A systematic review and meta-analysis. J Cosmet Dermatol 2022; 21:3636-3650. [PMID: 35861631 PMCID: PMC9350270 DOI: 10.1111/jocd.15261] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/02/2022] [Accepted: 07/18/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND COVID-19 vaccines are currently the most effective interventions in controlling and preventing severe disease progression. Dermatologic reactions to COVID-19 vaccinations may be rare among clinical trial participants. However, since global mass vaccination became a reality, these adverse effects may become more widespread, and different skin reactions would arise. OBJECTIVE To systematically review the cutaneous adverse reactions in cases subject to vaccines for COVID-19. METHODS We searched the PubMed, SCOPUS, Web of Science, and Embase databases, identifying the relevant records and including the eligible observational ones. After assessing the methodological quality of the included studies, we qualitatively and quantitatively synthesized the data regarding the cutaneous side effects experienced by those in the studies' population. RESULTS Overall, 36 studies were included in our systematic review, with the majority being cross-sectional. We found that pain, erythema, and swelling were the most common local side effects, while different types of rashes, urticaria, and angioedema were the most non-local. Few cases also reported experiencing flare-ups of their underlying diseases or developing newly-onset diseases of various etiologies. Our meta-analyses also found that while viral vector-based vaccines are, though insignificantly, safer in injection site complaints, individuals who received mRNA vaccines developed significantly fewer non-local cutaneous adverse events. DISCUSSION Cutaneous reactions to the COVID-19 vaccines are similar to common cutaneous drug eruptions and COVID-19 cutaneous manifestations. However, we believe that further high-quality research is needed to assess better how and why cutaneous reactions occur in different vaccines.
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Affiliation(s)
| | - Marzieh Jamali
- Gene Therapy Research CenterDigestive Diseases Research Institute, Tehran University of Medical SciencesTehranIran
| | - Zahra Akbari
- Faculty of MedicineKerman University of Medical SciencesKermanIran
| | | | - Mohadese Ahmadzade
- Departments of Plastic SurgeryShahid Beheshti University of Medical SciencesTehranIran
| | - Najmeh Ahramiyanpour
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of MedicineKerman University of Medical SciencesKermanIran
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13
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Batta S, Miller AC, Adjei S, Temiz LA, Tyring SK. Erythema multiforme after third COVID-19 vaccination (Pfizer-BioNTech). Proc AMIA Symp 2022; 35:811-812. [DOI: 10.1080/08998280.2022.2097572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
| | | | | | - Laurie A. Temiz
- Center for Clinical Studies, Webster, Texas
- Meharry Medical School, Nashville, Tennessee
| | - Stephen K. Tyring
- Center for Clinical Studies, Webster, Texas
- Department of Dermatology, University of Texas Health Science Center, Houston, Texas
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14
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Bardazzi F, Carpanese MA, Abbenante D, Filippi F, Sacchelli L, Loi C. New-onset bullous pemphigoid and flare of pre-existing bullous pemphigoid after the third dose of the COVID-19 vaccine. Dermatol Ther 2022; 35:e15555. [PMID: 35510556 PMCID: PMC9347770 DOI: 10.1111/dth.15555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/04/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Federico Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy
| | - Miriam Anna Carpanese
- Dermatology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy
| | - Diego Abbenante
- Dermatology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy
| | - Federica Filippi
- Dermatology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy
| | - Lidia Sacchelli
- Dermatology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy
| | - Camilla Loi
- Dermatology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, Italy
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15
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Aryanian Z, Balighi K, Hatami P, Tootoonchi NM, Goodarzi A, Mohseni Afshar Z. Morphea in two patients after being infected to and being vaccinated against SARS‐CoV‐2 infection. Clin Case Rep 2022; 10:e05667. [PMID: 35449768 PMCID: PMC9014706 DOI: 10.1002/ccr3.5667] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 03/20/2022] [Indexed: 12/17/2022] Open
Abstract
Although the presence of morphea following COVID‐19 has been rarely reported, the development of its generalized form following COVID‐19 vaccination has not been reported yet. Here, we reported the first case of generalized morphea following COVID‐19 vaccination and another similar case following SARS‐Cov‐2 infection. Other etiologic factors were also dealt with.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran
- Department of Dermatology Babol University of Medical Sciences Babol Iran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran
- Department of Dermatology Razi Hospital Tehran University of Medical Sciences Tehran Iran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran
| | - Nasim Mazloumi Tootoonchi
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran
- Department of Dermatology Razi Hospital Tehran University of Medical Sciences Tehran Iran
| | - Azadeh Goodarzi
- Department of Dermatology Rasoul‐e‐Akram Hospital Iran University of Medical Sciences Tehran Iran
- Skin and Stem Cell Research Center Tehran Iran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center Imam Reza Hospital Kermanshah University of Medical Sciences Kermanshah Iran
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16
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Delayed Cutaneous Adverse Reaction of the AstraZeneca COVID-19 Vaccine in a Breastfed Female Infant: A Coincidence or a Rare Effect? Vaccines (Basel) 2022; 10:vaccines10040602. [PMID: 35455352 PMCID: PMC9031970 DOI: 10.3390/vaccines10040602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
The ChAdOx1 nCoV-19 vector vaccine (Vaxzevria, AstraZeneca, Cambridge, UK) was developed at Oxford University and is considered safe for the administration in lactating mothers. Nevertheless, as a novel vaccine, there are gaps in the knowledge regarding possible adverse events in breastfeeding infants of vaccinated mothers. This case report provides first-time data on a possible delayed, cutaneous, adverse reaction in a breastfed, 16-month-old female infant after the first administration of the AstraZeneca vaccine to her 33-year-old mother. Even though, no clinical adverse effects were observed in the mother, her daughter had a 2-day rash in the lower extremities and face. The infant’s cutaneous rashes might be a coincidental event. However, all skin lesions were analogous to previous descriptions and photographs of dermatologic reactions, which resolved spontaneously with no medical intervention, in people who had been vaccinated with other COVID-19 vaccines. Our aim is that this short report contributes to the enhancement of parental awareness about the possibility of similar skin rashes in breastfed children when the mothers receive a vaccination and the importance of reporting those adverse reactions to the competent authorities.
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17
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Castillo JG, Gibert PR, Romero Abrio C, Parrón AM, Iglesias Martínez E, Arrue Michelena I, García Río I. "Erythema Multiforme after the third dose of mRNA-1273". Dermatol Ther 2022; 35:e15497. [PMID: 35388597 DOI: 10.1111/dth.15497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Pau Rosés Gibert
- Department of Dermatology, Hospital Universitario Araba, Vitoria, Spain
| | | | | | | | | | - Irene García Río
- Department of Dermatology, Hospital Universitario Araba, Vitoria, Spain
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18
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Malcolm TR, Shah YB. Woman with pruritic rash and dermatographism. J Am Coll Emerg Physicians Open 2022; 3:e12709. [PMID: 35356381 PMCID: PMC8948069 DOI: 10.1002/emp2.12709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/04/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Trent R. Malcolm
- Department of Emergency Medicine Jefferson Washington Township Hospital Jefferson Health New Jersey Sewell New Jersey USA
| | - Yash B. Shah
- Sidney Kimmel Medical College Thomas Jefferson University Philadelphia Pennsylvania USA
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19
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Affiliation(s)
- Astrid Herzum
- Dermatology Unit, U.O.C. Dermatologia e Centro Angiomi, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, Genova, Italy.
| | - Gianmaria Viglizzo
- Dermatology Unit, U.O.C. Dermatologia e Centro Angiomi, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, Genova, Italy
| | - Lodovica Gariazzo
- Dermatology Unit, U.O.C. Dermatologia e Centro Angiomi, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, Genova, Italy
| | - Jacopo Ferro
- Fetal and Perinatal Pathology Unit, U.O.C. Anatomia Patologica, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, Genova, Italy
| | - Valerio Gaetano Vellone
- Fetal and Perinatal Pathology Unit, U.O.C. Anatomia Patologica, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, Genova, Italy.
| | - Corrado Occella
- Dermatology Unit, U.O.C. Dermatologia e Centro Angiomi, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, Genova, Italy
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20
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Herzum A, Trave I, D’Agostino F, Burlando M, Cozzani E, Parodi A. Epstein-Barr virus reactivation after COVID-19 vaccination in a young immunocompetent man: a case report. Clin Exp Vaccine Res 2022; 11:222-225. [PMID: 35799871 PMCID: PMC9200649 DOI: 10.7774/cevr.2022.11.2.222] [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: 01/15/2022] [Accepted: 04/30/2022] [Indexed: 11/15/2022] Open
Abstract
We present the case of a 24-year-old Caucasian man, who developed a scaly erythematous skin rash after the second dose of coronavirus disease 2019 (COVID-19) vaccination with Comirnaty (BNT162b2, BioNTech/Pfizer; Pfizer, New York, NY, USA) and proved positive for Epstein-Barr virus (EBV) reactivation. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines have been associated with an up-regulated T helper type 1-cell response, possibly favoring an immune system imbalance. Also, EBV reactivation has been postulated after COVID-19 vaccination, but only in the immunosuppressed. Noteworthy we report the first case of EBV viral reactivation associated with cutaneous manifestations in an immunocompetent patient after the COVID-19 vaccine.
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Affiliation(s)
- Astrid Herzum
- Department of Dermatology, Di.S.Sal., University of Genoa, San Martino Polyclinic Hospital IRCCS, Genoa, Italy
| | - Ilaria Trave
- Department of Dermatology, Di.S.Sal., University of Genoa, San Martino Polyclinic Hospital IRCCS, Genoa, Italy
| | - Federica D’Agostino
- Department of Dermatology, Di.S.Sal., University of Genoa, San Martino Polyclinic Hospital IRCCS, Genoa, Italy
| | - Martina Burlando
- Department of Dermatology, Di.S.Sal., University of Genoa, San Martino Polyclinic Hospital IRCCS, Genoa, Italy
| | - Emanuele Cozzani
- Department of Dermatology, Di.S.Sal., University of Genoa, San Martino Polyclinic Hospital IRCCS, Genoa, Italy
| | - Aurora Parodi
- Department of Dermatology, Di.S.Sal., University of Genoa, San Martino Polyclinic Hospital IRCCS, Genoa, Italy
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21
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Burlando M, Herzum A, Micalizzi C, Cozzani E, Parodi A. Cutaneous reactions to COVID-19 vaccine at the dermatology primary care. Immun Inflamm Dis 2021; 10:265-271. [PMID: 34837354 PMCID: PMC8767505 DOI: 10.1002/iid3.568] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction Coronavirus disease 2019 (COVID‐19) vaccines can cause adverse reactions, mainly from vaccine‐induced immune responses. Some of these may also involve the skin and worry unaware patients. A better understanding of such adverse reactions may reduce concerns and help promote the vaccination of large population groups. Methods All the reports of patients admitted to our Dermatology Primary Care, from March 2021 to June 2021, were retrospectively examined to collect descriptive data on skin reactions arising after COVID‐19 vaccination. Results Out of 200 vaccinated patients admitted to the Dermatology Primary Care, 21 (10.5%) referred cutaneous reactions with onset after vaccination. Only one patient required hospitalization for generalized bullous erythema multiforme, which occurred 48 h after the second vaccine dose. The other patients' cutaneous reactions to vaccination were of mild/moderate degree. Three patients presented exacerbation of their cutaneous diseases. Conclusions Cutaneous reactions observed in our sample were mostly mild or moderate. Awareness must be raised to recognize and treat eventual severe reactions. Future studies are needed to assess the incidence of cutaneous reactions following COVID‐19 vaccination.
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Affiliation(s)
- Martina Burlando
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| | - Astrid Herzum
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| | - Claudia Micalizzi
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| | - Emanuele Cozzani
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| | - Aurora Parodi
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
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