A case of toxic epidermal necrolysis after ChAdOx1 nCov‐19 (AZD1222) vaccination

Kherlopian, Ashod; Zhao, Cathy; Ge, Ludi; Forward, Emily; Fischer, Gayle E.

doi:10.1111/ajd.13742

Cited by 8 publications

(9 citation statements)

References 6 publications

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“…Multiple authors have hypothesized that the virotope antigens delivered by COVID‐19 vaccines are expressed on the surfaces of keratinocytes and trigger the activation of cytotoxic CD8+ T‐cells. 2 , 9 , 10 , 11 , 12 , 13 These activated T‐cells then release granulysin, granzyme B, and perforin, which induce pore formation, apoptotic cascades in keratinocytes, and detachment at the dermo‐epidermal junction (DEJ). 2 , 11 , 12 Moreover, these T‐cells secrete significant amounts of cytokines including tumour necrosis factor‐ɑ (TNF‐ɑ) and interferon‐ɣ (IFN‐ɣ), which lead to the overexpression of Fas ligands that also mediate keratinocyte apoptosis.…”

Section: Discussionmentioning

confidence: 99%

Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

Zou

Daveluy

2022

Aust J Dermatology

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Stevens‐Johnson Syndrome (SJS) is a rare but severe skin reaction characterized by blistering and peeling of the skin and ulcerations of mucous membranes; toxic epidermal necrolysis (TEN) is a subset of SJS characterized by the involvement of >30% of the skin. Though previously associated with drugs and infections, discussions on the association between TEN/SJS and COVID‐19 have been limited. We present a review of TEN/SJS after COVID‐19 infection and vaccination. Literature searches were conducted on PubMed and Google Scholar from 2019 to 8/2022. Thirty‐eight articles were selected based on subject relevance, and references within selected articles were also screened for relevance. As of 8/2022, there have been 34 published cases of TEN, SJS, and SJS‐TEN overlap after COVID‐19 infection and vaccination, including 12 cases after vaccination and 22 cases after infection. Multiple authors hypothesize that virotopes or excipients in COVID‐19 vaccines can activate T‐cells or cytokines to induce TEN/SJS. Meanwhile, some hypothesize that COVID‐19 infection induces immune activation that can trigger TEN/SJS or increase susceptibility to drug‐induced TEN/SJS. Treatments for post‐infection and post‐vaccination TEN/SJS vary significantly. We recommend remaining vigilant for this rare and severe potential complication.

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Section: Discussionmentioning

confidence: 99%

Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

Zou

Daveluy

2022

Aust J Dermatology

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“…Cutaneous adverse reactions like hyperhidrosis, pruritis, urticaria, angioedema, post‐vaccination herpes zoster, pityriasis rosea, pityriasis rubra pilaris, erythema multiforme, erythema nodosum, generalized bullous‐fixed drug eruption, toxic epidermal necrolysis, and sweet syndrome have been reported following ChAdOx1 nCoV‐19 vaccine. 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 …”

Section: Discussionmentioning

confidence: 99%

Development of severe pemphigus vulgaris following ChAdOx1 nCoV‐19 vaccination and review of literature

Singh

Bharadwaj

et al. 2022

J of Cosmetic Dermatology

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Vaccines are indeed a boon for tackling the present COVID‐19 pandemic. In India, ChAdOx1 nCoV‐19 (Covishield) is the most commonly used vaccine in the government vaccination program for adults more than 18 years of age. It is a recombinant vaccine developed by Oxford‐Astra Zeneca and manufactured in India by Serum Institute of India (SSI). Here, we report a case of severe pemphigus vulgaris following the second dose of ChAdOx1 nCoV‐19 vaccination in an adult male. The patient developed septicemia during the course of hospital stay, and he was managed with systemic steroids, parenteral antibiotics, and intravenous immunoglobulins (IVIg) along with proper wound care. Patient started improving within 1 month of therapy. This case is being reported in view of the rarity of pemphigus vulgaris following ChAdOx1 nCoV‐19 vaccine.

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“…In addition, cases of SJS/TEN associated with the COVID-19 vaccine have been rarely reported and are summarized in Table 1. [4][5][6][7][8][9][10][11][12] There have been only nine reported cases of SJS/TEN after COVID-19 vaccine. Five of these patients had underlying diseases, such as hyperlipidemia, diabetes mellitus and breast cancer with a history of medication use.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, cases of SJS/TEN associated with the COVID‐19 vaccine have been rarely reported and are summarized in Table 1 . 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 …”

Section: Discussionmentioning

confidence: 99%

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Toxic epidermal necrolysis after first dose of Pfizer‐BioNTech (BNT162b2) vaccination with pharmacogenomic testing

Siripipattanamongkol

Rattanasak

Taiyaitieng

et al. 2022

Pediatric Dermatology

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A case of toxic epidermal necrolysis after ChAdOx1 nCov‐19 (AZD1222) vaccination

Cited by 8 publications

References 6 publications

Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

Development of severe pemphigus vulgaris following ChAdOx1 nCoV‐19 vaccination and review of literature

Toxic epidermal necrolysis after first dose of Pfizer‐BioNTech (BNT162b2) vaccination with pharmacogenomic testing

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