Correspondence urticarial and morbilliform eruptions. Less frequently seen reactions included chilblains, cosmetic filler reactions, herpes zoster or herpes simplex flares, and pityriasis rosea-like reactions. Only two patients had cutaneous vasculitis. Lupus-like skin lesions or lupus deterioration were not reported. 7 Strong agreement exists that all patients with autoimmune rheumatic diseases should be vaccinated against COVID-19. However, SARS-CoV-2 vaccination should be considered as a potential trigger of disease flares, especially in individuals with certain ANA constellations (e.g. anti-Ro/SSA and anti-La/SSB antibodies) predisposing for CLE.

Dear Editor,The recent approval of highly effective prophylactic vaccines against COVID-19 is a monumental step in the global fight against the ongoing SARS-CoV-2 pandemic. Two types of SARS-CoV-2 vaccines are currently used, messenger-RNA (mRNA) vaccines and recombinant adenoviral (AdV) vector vaccines. 1 Both of them encode the production of the SARS-CoV-2 spike protein, which is the primary target for neutralizing antibodies. We report a case of subacute cutaneous lupus erythematosus (SCLE) that transitioned into systemic lupus erythematosus (SLE) following AdV-vaccination with AZD1222.A 62-year-old woman presented with a generalized morbilliform exanthema and new onset of fatigue and musculoskeletal pain (Fig. 1). Six months before the first visit to our department, the patient had experienced erythematosquamous papules and plaques symmetrically located in the sun-exposed areas (chest, upper back, lower arms, and dorsal hands). Laboratory investigations found a normal blood cell count and serum chemistry, but increased titres for antinuclear antibodies (1 : 320; normal <1 : 160) and positivity for anti-Ro/SSA(60) antibodies. All other extractable nuclear antigens were unremarkable. Further

The mechanism of onychomadesis (nail shedding) and beau's lines following hand-foot-mouth disease.

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