Systemic Sarcoidosis with Cutaneous Tattoo Involvement Following COVID-19 Vaccination

Sarcoidosis and COVID-19 Vaccines: A Systematic Review of Case Reports and Case Series

COVID-19 vaccines play a crucial role in preventing complications and alleviating the impact of SARS-CoV-2. Nevertheless, these vaccines have been associated with side effects like pain, fatigue, fever, and, in rare instances, the development of sarcoidosis. This review seeks to provide an overview of research on sarcoidosis occurring after COVID-19 vaccination and attempt to identify potential factors that may contribute to this uncommon yet concerning complication. Our review protocol was registered on PROSPERO with ID: (CRD42023463854). We comprehensively searched five electronic databases (PubMed, Scopus, Web of Science, EMBASE, Cochrane) from August, 22 2023 until September, 1st 2023. We finally had 12 studies after the first and second scans. We used SPSS to analyse the extracted data. We included 31 participants who experienced lung sarcoidosis following COVID-19 vaccination, with 61.3% female, and 38.7% male. The study showed that most events were observed in individuals who got Pfizer-BioNTech or Moderna vaccines, particularly after the second dosage. Pain, local erythema, ulceration or swelling at the injection site, fever, urticaria, pityriasiform rash, and erythema multiforme were some of the most common presenting symptoms. A biopsy was the major diagnostic method. Other modalities were used, including a complete blood count, CT scans, and X-rays. Sarcoidosis has been shown in a limited number of individuals who got the COVID-19 vaccination; however, it is unclear if the vaccine is directly responsible for this condition. However, the COVID-19 vaccines are both safe and effective in preventing the disease, and the advantages of immunisation outweigh any potential risks.

Cutaneous adverse reactions associated with COVID-19 vaccines: Current evidence and potential immune mechanisms

As the number of vaccinated individuals has increased, there have been increasing reports of cutaneous hypersensitivity reactions. The main COVID-19 vaccines administered include messenger ribonucleic acid vaccines, non-replicating viral vector vaccines, inactivated whole-virus vaccines, and protein-based vaccines. These vaccines contain active components such as polyethylene glycol, polysorbate 80, aluminum, tromethamine, and disodium edetate dihydrate. Recent advances in understanding the coordination of inflammatory responses by specific subsets of lymphocytes have led to a new classification based on immune response patterns. We categorize these responses into four patterns: T helper (Th)1-, Th2-, Th17/22-, and Treg-polarized cutaneous inflammation after stimulation of COVID-19 vaccines. Although the association between COVID-19 vaccination and these cutaneous adverse reactions remains controversial, the occurrence of rare dermatoses and their short intervals suggest a possible relationship. Despite the potential adverse reactions, the administration of COVID-19 vaccines is crucial in the ongoing battle against severe acute respiratory syndrome coronavirus 2.

New-Onset Rheumatic Immune-Mediated Inflammatory Diseases Following SARS-CoV-2 Vaccinations until May 2023: A Systematic Review

A comprehensive, up-to-date systematic review (SR) of the new-onset rheumatic immune-mediated inflammatory diseases (R-IMIDs) following COVID-19 vaccinations is lacking. Therefore, we investigated the demographics, management, and prognosis of new R-IMIDs in adults following SARS-CoV-2 vaccinations. A systematic literature search of Medline, Embase, Google Scholar, LitCovid, and Cochrane was conducted. We included any English-language study that reported new-onset R-IMID in adults following the post-COVID-19 vaccination. A total of 271 cases were reported from 39 countries between January 2021 and May 2023. The mean age of patients was 56 (range 18-90), and most were females (170, 62.5%). Most (153, 56.5%) received the Pfizer BioNTech COVID-19 vaccine. Nearly 50% of patients developed R-IMID after the second dose of the vaccine. Vasculitis was the most prevalent clinical presentation (86, 31.7%), followed by connective tissue disease (66, 24.3%). The mean duration between the vaccine's 'trigger' dose and R-IMID was 11 days. Most (220, 81.2%) received corticosteroids; however, 42% (115) received DMARDs such as methotrexate, cyclophosphamide, tocilizumab, anakinra, IV immunoglobulins, plasma exchange, or rituximab. Complete remission was achieved in 75 patients (27.7%), and 137 (50.6%) improved following the treatment. Two patients died due to myositis. This SR highlights that SARS-CoV-2 vaccines may trigger R-IMID; however, further epidemiology studies are required.