Late-onset pustular skin eruption in a healthy neonate born from COVID-positive mother: a coincidence or a new skin sign of the infection?

Delayed Cutaneous Adverse Reaction of the AstraZeneca COVID-19 Vaccine in a Breastfed Female Infant: A Coincidence or a Rare Effect?

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.

Perinatal/maternal-fetal-infant dermatologic manifestations of SARS-CoV-2. An Overview and Implications for diagnosis, treatment, and prognosis

Early identification of the dermatologic manifestations of SARS-CoV-2 in perinatal and maternal-fetal-infant populations is essential for early intervention in the diagnosis, treatment, and prevention of short and long term sequelae. Although cutaneous signs of SARS-CoV-2 are less common in pregnant women, neonates, and infants, the recognition of related skin lesions with regard to timing, location, duration, and pattern can lead to determining disease severity. While many pediatric patients may be asymptomatic with negative SARS-CoV-2 testing, skin lesions may be the only clue of infection. SARS-CoV-2 infection in pregnancy can lead to severe life threatening illness and by understanding the cutaneous manifestations associated with SARS-CoV-2 infection, early diagnosis can be made with improved maternal-fetal outcomes. A wide array of dermatologic presentations associated with SARS-CoV-2 are reported in the literature. This review explores the expanding reports in the literature of the dermatologic presentations of skin lesions related to SARS-CoV-2 specifically in perinatal and maternal-fetal-infant health and the implications for management. The collaboration of the specialties of dermatology, pediatrics, obstetrics/gynecology, and infectious disease in the approach to SARS-CoV-2 disease can lead to a better understanding of the scope and presentation of this disease.