Vaccine-related erythema nodosum is uncommon, especially after the coronavirus disease 2019 (COVID-19) vaccine. This study presents the first case of the Pfizer vaccine associated with erythema nodosum. A 22-year-old healthy woman presented with a five-day history of several red painful areas with swelling in the lower extremities that started one day after receiving the first dose of Pfizer vaccine. Past medical history, laboratory investigation, and chest radiograph revealed normal results. Erythema nodosum is an immune reaction that manifests as multiple, painful nodules commonly seen on the shin that resolved spontaneously two to eight weeks after the onset. In the absence of laboratory and chest radiograph abnormalities and shortly after receiving the Pfizer vaccine, vaccine-related erythema nodosum is the only possible explanation.

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Sjögren's syndrome (SjS) is a chronic autoimmune disease with a tendency to inflame the exocrine glands, and hepatitis C virus (HCV) infection is considered an exclusion criterion for the diagnosis of this condition; however, it is a highly debated topic, mainly because HCV is viewed as a possible etiopathogenic factor in the disease onset. We report a case of a female patient diagnosed with HCV chronic infection with positive serological markers of SjS (anti-Ro and anti-La autoantibodies). She presented with neuropsychiatric manifestations and casual sicca symptoms and was eventually diagnosed with HCV-induced SjS. Initially, the patient developed symptoms that fulfilled the histopathological criteria of primary SjS and co-existence of mixed cryoglobulinemia, which is viewed as an HCV-related marker.