BCG Scar Local Skin Inflammation as a Novel Reaction Following mRNA COVID-19 Vaccines in Two International Healthcare Workers

Lopatynsky-Reyes, Erika Zoe; Acosta-Lazo, Heidy; Ulloa‐Gutiérrez, Rolando; Ávila-Agüero, María Luisa; Chacón-Cruz, Enrique

doi:10.7759/cureus.14453

Cited by 22 publications

(36 citation statements)

References 16 publications

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“…Generation of granulomas is a physiological tool to limit the extension of pathogens or foreign bodies that cannot be eliminated. Another interesting phenomenon was described by Lopatynsky-Reyes et al in terms of local skin inflammation of BCG vaccine scars after COVID-19 vaccines in health care workers [ 85 ]. Although there are no published case reports at this time, other specific granulomatous dermatoses such as granuloma annulare or cutaneous sarcoidosis might occur with COVID-19 vaccines, as they have been described in the course of other vaccines [ 86 , 87 ].…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective

et al. 2021

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(1) Background: Numerous vaccines are under preclinical and clinical development for prevention of severe course and lethal outcome of coronavirus disease 2019 (COVID-19). In light of high efficacy rates and satisfactory safety profiles, some agents have already reached approval and are now distributed worldwide, with varying availability. Real-world data on cutaneous adverse drug reactions (ADRs) remain limited. (2) Methods: We performed a literature research concerning cutaneous ADRs to different COVID-19 vaccines, and incorporated our own experiences. (3) Results: Injection site reactions are the most frequent side effects arising from all vaccine types. Moreover, delayed cutaneous ADRs may occur after several days, either as a primary manifestation or as a flare of a pre-existing inflammatory dermatosis. Cutaneous ADRs may be divided according to their cytokine profile, based on the preponderance of specific T-cell subsets (i.e., Th1, Th2, Th17/22, Tregs). Specific cutaneous ADRs mimic immunogenic reactions to the natural infection with SARS-CoV-2, which is associated with an abundance of type I interferons. (4) Conclusions: Further studies are required in order to determine the best suitable vaccine type for individual groups of patients, including patients suffering from chronic inflammatory dermatoses.

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Section: Discussionmentioning

confidence: 99%

Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective

et al. 2021

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“…There is general consensus that an absolute contraindication to COVID-19 vaccination is a known hypersensitivity to ingredients of the vaccine. Patients with lower and medium risk for SARS-CoV-19 vaccination should be monitored for at least 15 or 30 min after injection [ 43 ]. For a number of other vaccines, public safety data are sparse or missing [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Cutaneous and hypersensitivity reactions associated with COVID-19 vaccination—a narrative review

Wollina

Chiriac

Kocic

et al. 2021

Wien Med Wochenschr

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Vaccination against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV‑2) has become a major tool in the battle against the coronavirus disease 2019 (COVID-19) pandemic. Numerous products have been developed and more are to come. Vaccination success varies greatly between different countries. There are a number of different vaccine types, such as mRNA, DNA vaccines, adenovirus vector vaccines, and full-length spike protein nanoparticles with a special matrix. The different types may also cause a different spectrum of adverse events. With mass vaccination, post-marketing surveillance for product safety becomes increasingly important. In this review, we discuss possible hypersensitivity and cutaneous adverse events related to SARS-CoV‑2 vaccination—from local reactions like COVID arm to systemic and severe reactions like anaphylaxis. Vaccination may also induce or exacerbate preexisting disorders such as herpes zoster infection. This review should provide information to tailor, whenever possible, vaccination to patients’ needs. It is a contribution to patient safety as well. There is general consensus that the benefits of SARS-CoV‑2 vaccination currently outweigh the risks of possible adverse events.

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“…Another recently described local skin reaction following Comirnaty ® and Moderna ® vaccination was reported by Lopatynsky‐Reyes et al . 9 In two adults, they observed about 1 day after the second vaccination local skin inflammation in sites of previous Bacillus Calmette‐Guérin (BCG) vaccination scars. The inflammatory process in the old BCG scars was also accompanied by shortly transient systemic symptoms, such as headache, malaise, myalgia and arthralgia.…”

Section: Type I and Type Iv Hypersensitivity Reactionsmentioning

confidence: 99%

“…chilblain‐like lesions, morbilliform rashes and vasculitis) SARS‐CoV‐2 vaccines appear to have also the potential to induce a broad spectrum of cutaneous adverse events. 1 , 2 , 3 , 4 , 5 In this review article, 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , …”

Section: Introductionmentioning

confidence: 99%

Cutaneous findings following COVID‐19 vaccination: review of world literature and own experience

Gambichler

Boms²,

Susok

et al. 2021

Acad Dermatol Venereol

176

237

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There is growing evidence that not only the novel coronavirus disease (COVID‐19) but also the COVID‐19 vaccines can cause a variety of skin reactions. In this review article, we provide a brief overview on cutaneous findings that have been observed since the emerging mass COVID‐19 vaccination campaigns all over the world. Unspecific injection‐site reactions very early occurring after the vaccination are most frequent. Type I hypersensitivity reactions (e.g. urticaria, angio‐oedema and anaphylaxis) likely due to allergy to ingredients may rarely occur but can be severe. Type IV hypersensitivity reactions may be observed, including delayed large local skin lesions (“COVID arm”), inflammatory reactions in dermal filler or previous radiation sites or even old BCG scars, and more commonly morbilliform and erythema multiforme‐like rashes. Autoimmune‐mediated skin findings after COVID‐19 vaccination include leucocytoclastic vasculitis, lupus erythematosus and immune thrombocytopenia. Functional angiopathies (chilblain‐like lesions, erythromelalgia) may also be observed. Pityriasis rosea‐like rashes and reactivation of herpes zoster have also been reported after COVID‐19 vaccination. In conclusion, there are numerous cutaneous reaction patterns that may occur following COVID‐19 vaccination, whereby many of these skin findings are of immunological/autoimmunological nature. Importantly, molecular mimicry exists between SARS‐CoV‐2 (e.g. the spike‐protein sequences used to design the vaccines) and human components and may thus explain some COVID‐19 pathologies as well as adverse skin reactions to COVID‐19 vaccinations.

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BCG Scar Local Skin Inflammation as a Novel Reaction Following mRNA COVID-19 Vaccines in Two International Healthcare Workers

Abstract: Lopatynsky-Reyes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 22 publications

References 16 publications

Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective

Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective

Cutaneous and hypersensitivity reactions associated with COVID-19 vaccination—a narrative review

Cutaneous findings following COVID‐19 vaccination: review of world literature and own experience

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