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Català A, Muñoz-Santos C, Galván-Casas C, Roncero Riesco M, Revilla Nebreda D, Solá-Truyols A, Giavedoni P, Llamas-Velasco M, González-Cruz C, Cubiró X, Ruíz-Villaverde R, Gómez-Armayones S, Gil Mateo MP, Pesqué D, Marcantonio O, Fernández-Nieto D, Romaní J, Iglesias Pena N, Carnero Gonzalez L, Tercedor-Sanchez J, Carretero G, Masat-Ticó T, Rodríguez-Jiménez P, Gimenez-Arnau AM, Utrera-Busquets M, Vargas Laguna E, Angulo Menéndez AG, San Juan Lasser E, Iglesias-Sancho M, Alonso Naranjo L, Hiltun I, Cutillas Marco E, Polimon Olabarrieta I, Marinero Escobedo S, García-Navarro X, Calderón Gutiérrez MJ, Baeza-Hernández G, Bou Camps L, Toledo-Pastrana T, Guilabert A. Cutaneous reactions after SARS-COV-2 vaccination: A cross-sectional Spanish nationwide study of 405 cases. Br J Dermatol 2021; 186:142-152. [PMID: 34254291 PMCID: PMC8444756 DOI: 10.1111/bjd.20639] [Citation(s) in RCA: 145] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/05/2021] [Accepted: 07/10/2021] [Indexed: 11/30/2022]
Abstract
Background Cutaneous reactions after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines are poorly characterized. Objective To describe and classify cutaneous reactions after SARS‐CoV‐2 vaccination. Methods A nationwide Spanish cross‐sectional study was conducted. We included patients with cutaneous reactions within 21 days of any dose of the approved vaccines at the time of the study. After a face‐to‐face visit with a dermatologist, information on cutaneous reactions was collected via an online professional survey and clinical photographs were sent by email. Investigators searched for consensus on clinical patterns and classification. Results From 16 February to 15 May 2021, we collected 405 reactions after vaccination with the BNT162b2 (Pfizer‐BioNTech; 40·2%), mRNA‐1273 (Moderna; 36·3%) and AZD1222 (AstraZeneca; 23·5%) vaccines. Mean patient age was 50·7 years and 80·2% were female. Cutaneous reactions were classified as injection site (‘COVID arm’, 32·1%), urticaria (14·6%), morbilliform (8·9%), papulovesicular (6·4%), pityriasis rosea‐like (4·9%) and purpuric (4%) reactions. Varicella zoster and herpes simplex virus reactivations accounted for 13·8% of reactions. The COVID arm was almost exclusive to women (95·4%). The most reported reactions in each vaccine group were COVID arm (mRNA‐1273, Moderna, 61·9%), varicella zoster virus reactivation (BNT162b2, Pfizer‐BioNTech, 17·2%) and urticaria (AZD1222, AstraZeneca, 21·1%). Most reactions to the mRNA‐1273 (Moderna) vaccine were described in women (90·5%). Eighty reactions (21%) were classified as severe/very severe and 81% required treatment. Conclusions Cutaneous reactions after SARS‐CoV‐2 vaccination are heterogeneous. Most are mild‐to‐moderate and self‐limiting, although severe/very severe reactions are reported. Knowledge of these reactions during mass vaccination may help healthcare professionals and reassure patients. What is already known about this topic?In clinical trials, COVID‐19 vaccines were associated with cutaneous adverse events, especially local injection site reactions. Previous descriptions of cutaneous reactions beyond the injection site were case reports or mostly reported by non‐dermatologists and lacked clinical images.
What does this study add?We describe and classify a large, representative sample of patients with unexplained skin manifestations after COVID‐19 vaccination, using consensus to define associated morphological patterns. We describe six morphological reaction patterns and herpesvirus reactivations, and their association with demographic factors and the medical record, and provide illustrations to allow for easy recognition.
Linked Comment: V. Bataille and S. Puig. Br J Dermatol 2022; 186:15. Plain language summary available online
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Affiliation(s)
- A Català
- Servicio de Dermatología. Hospital Clínic, Barcelona, Spain
| | - C Muñoz-Santos
- Servicio de Dermatología. Hospital General de Granollers, Barcelona, Spain
| | - C Galván-Casas
- Servicio de Dermatología. Hospital Universitario de Móstoles, Madrid, Spain
| | - M Roncero Riesco
- Servicio de Dermatología. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - D Revilla Nebreda
- Servicio de Dermatología. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - A Solá-Truyols
- Servicio de Dermatología. Hospital Universitario Son Llatzer, Mallorca, Spain
| | - P Giavedoni
- Servicio de Dermatología. Hospital Clínic, Barcelona, Spain
| | - M Llamas-Velasco
- Servicio de Dermatología. Hospital Universitario de La Princesa, Madrid, Spain
| | - C González-Cruz
- Servicio de Dermatología. Hospital, Universitari Vall D'Hebron, Barcelona, Spain
| | - X Cubiró
- Servicio de Dermatología. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - R Ruíz-Villaverde
- Servicio de Dermatología. Hospital Universitario San Cecilio, Granada, Spain
| | | | - M P Gil Mateo
- Servicio de Dermatología. Hospital General de La Palma. Santa Cruz de Tenerife, Spain
| | - D Pesqué
- Servicio de Dermatología. Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | - O Marcantonio
- Servicio de Dermatología. Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | | | - J Romaní
- Servicio de Dermatología, Parc Taulí Hospital Universitari. Sabadell, Barcelona, Spain
| | - N Iglesias Pena
- Servicio de Dermatología. Hospital, Universitario Lucus Augusti, Lugo, Spain
| | | | | | - G Carretero
- Servicio de Dermatología.Hospital Universitario Gran Canaria Doctor Negrín, Las Palmas Gran Canaria, Spain
| | - T Masat-Ticó
- CAP Cardedeu. Institut Català de la Salut, Barcelona, Spain
| | - P Rodríguez-Jiménez
- Servicio de Dermatología. Hospital Universitario de La Princesa, Madrid, Spain
| | - A M Gimenez-Arnau
- Servicio de Dermatología. Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | - M Utrera-Busquets
- Servicio de Dermatología. Hospital Comarcal Infanta Elena, Huelva, Spain
| | - E Vargas Laguna
- Servicio de Dermatología. Hospital, Universitario Severo Ochoa, Madrid, Spain
| | - A G Angulo Menéndez
- Servicio de Dermatología. Serveis Medics Penedés Vilanova i la Geltrú, Barcelona, Spain
| | | | - M Iglesias-Sancho
- Servicio de Dermatología. Hospital, Universitari Sagrat Cor, Barcelona, Spain
| | - L Alonso Naranjo
- Servicio de Dermatología. Hospital Universitario de Toledo, Toledo, Spain
| | - I Hiltun
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Navarra, Spain
| | - E Cutillas Marco
- Servicio de Dermatología. Hospital General, Universitario Reina Sofia, Murcia, Spain
| | | | | | - X García-Navarro
- Servicio de Dermatología. Consorci Sanitari Alt Penedès-Garraf, Barcelona, Spain
| | | | - G Baeza-Hernández
- Servicio de Dermatología. Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - A Guilabert
- Servicio de Dermatología. Hospital General de Granollers, Barcelona, Spain
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Salleras M, Alegre M, Alonso-Usero V, Boixeda P, Domínguez-Silva J, Fernández-Herrera J, García-Navarro X, Jiménez N, Llamas M, Nadal C, Del Pozo-Losada J, Querol I, Salgüero I, Schaller M, Soto de Delás J. Spanish Consensus Document on the Treatment Algorithm for Rosacea. Actas Dermosifiliogr (Engl Ed) 2019; 110:533-545. [PMID: 30837074 DOI: 10.1016/j.ad.2019.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/28/2018] [Accepted: 01/01/2019] [Indexed: 01/11/2023] Open
Abstract
Recent scientific evidence and the incorporation of new drugs into the therapeutic arsenal against rosacea have made it necessary to review and update treatment criteria and strategies. To this end, a panel of 15 dermatologists, all experts in rosacea, was formed to share experiences and discuss treatment options, response criteria, and changes to treatment. Based on a critical review of the literature and a discussion of the routine practices of Spanish dermatologists, the panel proposed and debated different options, with consideration of the experience of professionals and the preferences of patients or equality criteria. Following validation of the proposals, the final recommendations were formulated and, together with the evidence from the main international guidelines and studies, used to produce this consensus document. The goal of this consensus document is to provide dermatologists with practical recommendations for the management of rosacea.
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Affiliation(s)
- M Salleras
- Servicio de Dermatología, Hospital Universitario Sagrado Corazón, Barcelona, España.
| | - M Alegre
- Servicio de Dermatología, Hospital Plató, Barcelona, España
| | - V Alonso-Usero
- Servicio de Dermatología, Hospital Nisa 9 de Octubre, Valencia, España
| | - P Boixeda
- Sección de Dermatología, Hospital Ramón y Cajal, Madrid, España
| | - J Domínguez-Silva
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | | | - X García-Navarro
- Servicio de Dermatología, Consorci Sanitari del Garraf, Barcelona, España
| | - N Jiménez
- Sección de Dermatología, Hospital Ramón y Cajal, Madrid, España
| | - M Llamas
- Sección de Dermatología, Hospital de La Princesa, Madrid, España
| | - C Nadal
- Servicio de Dermatología, Hospital Son Llatzer, Palma de Mallorca, España
| | - J Del Pozo-Losada
- Servicio de Dermatología, Hospital Universitario A Coruña, La Coruña, España
| | - I Querol
- Universidad de Zaragoza, Zaragoza, España
| | - I Salgüero
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - M Schaller
- Departamento de Dermatología, Universidad de Klinikum, Tubinga, Alemania
| | - J Soto de Delás
- Servicio de Dermatología, Policlínica Gipuzkoa, San Sebastián, España
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Curto-Barredo L, Spertino J, Figueras-Nart I, Expósito-Serrano V, Guilabert A, Melé-Ninot G, Cubiró X, Bonfill-Ortí M, Garcias-Ladaria J, Villar M, García-Navarro X, Bielsa-Marsol I, Vilavella M, Aparicio G, Baliu-Piqué C, Álvarez A, Lamas-Domenech N, Duran-Jordà X, Serra-Baldrich E, Giménez-Arnau A. Omalizumab updosing allows disease activity control in patients with refractory chronic spontaneous urticaria. Br J Dermatol 2018; 179:210-212. [DOI: 10.1111/bjd.16379] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- L. Curto-Barredo
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - J. Spertino
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - I. Figueras-Nart
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - V. Expósito-Serrano
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - A. Guilabert
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - G. Melé-Ninot
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - X. Cubiró
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - M. Bonfill-Ortí
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - J. Garcias-Ladaria
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - M. Villar
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - X. García-Navarro
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - I. Bielsa-Marsol
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - M. Vilavella
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - G. Aparicio
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - C. Baliu-Piqué
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - A. Álvarez
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - N. Lamas-Domenech
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - X. Duran-Jordà
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - E. Serra-Baldrich
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
| | - A. Giménez-Arnau
- Hospital del Mar Medical Research Institute (IMIM); Universitat Autònoma Barcelona, (UAB) - Dermatology; Barcelona Catalunya Spain
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