Bullous pemphigoid and COVID-19 vaccine

Pérez-López, Israel; Moyano-Bueno, David; Ruíz‐Villaverde, Ricardo

doi:10.1016/j.medcle.2021.05.004

Cited by 29 publications

(36 citation statements)

References 5 publications

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“…Median age at onset (81 years) was in line with published observations [82.5 (IQR: 71.25–84.75) years; n = 24/34 with age available] ( 23 – 28 ). Likewise, sex distribution showed a slight male sex preference in both our cohort (M:F = 1.3) and available reports (M:F = 1.2; n = 22 with gender available) ( 23 – 28 ).…”

Section: Discussionsupporting

confidence: 87%

“…SARS-CoV-2-vaccine-associated cutaneous eruptions encompass a growing spectrum of clinicopathological varieties, including local injection site reactions, urticarial eruptions, morbilliform eruptions, pernio/chilblain-like lesions, cosmetic filler reactions, herpes zoster and herpes simplex flares, pityriasis rosea-like eruptions (11,20,21). Autoimmune bullous skin diseases have also been observed following SARS-CoV-2-vaccination, with approximately 34 individual cases of vaccine-associated BP currently described (12,14,17,(22)(23)(24)(25)(26)(27)(28) (Supplementary Table 1). According to the registry-based studies by McMahon et al, BP-like eruptions accounted for 20% (12/58) of biopsy-proven SARS-CoV-2-vaccine-associated cutaneous reactions and 1.5% overall (11,22).…”

Section: Discussionmentioning

confidence: 99%

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Bullous Pemphigoid Associated With COVID-19 Vaccines: An Italian Multicentre Study

et al. 2022

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Bullous pemphigoid (BP) is an autoimmune bullous disease caused by circulating autoantibodies toward the hemidesmosomal antigens BP180 and BP230. Cases of BP have been described following vaccinations against tetanus, poliomyelitis, diphtheria, influenza, pneumococcus, meningococcus, hepatitis B and rabies. The putative mechanism by which COVID-19-vaccines may induce BP has not been clarified. An Italian multicentre study was conducted to collect clinical, histopathological and immunopathological data of patients with BP associated with COVID-19-vaccines. Twenty-one cases were collected, including 9 females and 12 males (M/F = 1.3) with a median age at diagnosis of 82 years. Seventeen patients received the COMIRNATY Pfizer-BioNTech vaccine, two the Moderna mRNA-1273 vaccine, one the ChAdOx1/nCoV-19-AstraZeneca/ Vaxzevria vaccine and one received the first dose with the ChAdOx1/nCoV-19-AstraZeneca/Vaxzevria vaccine and the second dose with the COMIRNATY Pfizer-BioNTech vaccine. Median latency time between the first dose of anti-SARS-CoV-2 vaccine and the onset of cutaneous manifestations was 27 days. Median BPDAI at onset was 42. Eleven out of seventeen patients (65%) had positive titres for anti-BP180 antibodies with a median value of 106.3 U/mL on ELISA; in contrast, only five out of seventeen (29%) were positive for anti-BP230 antibodies, with a median of 35.3 U/mL. In conclusion, in terms of mean age, disease severity at diagnosis and clinical phenotype vaccine-associated BP patients seem to be similar to idiopathic BP with an overall benign course with appropriate treatment. On the other hand, the slight male predominance and the reduced humoral response to BP230 represent peculiar features of this subset of patients.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Bullous Pemphigoid Associated With COVID-19 Vaccines: An Italian Multicentre Study

et al. 2022

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“…So far, there are very limited data regarding autoimmune skin diseases following SARS‐CoV‐2 vaccines (Fig. 1), even though other vaccines have previously been reported to be potential triggers for conditions, such as lupus erythematosus (LE), bullous pemphigoid, leucocytoclastic vasculitis, vitiligo, and alopecia areata 36,66,67 …”

Section: Autoimmune‐mediated Reactionsmentioning

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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“…BP is characterized by the appearance of tense blisters on an erythematous base and the existence of circulating IgG against BP180 and BP230 antigens of hemidesmosomes [ 5 ]. However, the role of vaccines in the onset of BP is not completely elucidated.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Bullous Dermatosis Following COVID-19 Vaccination: A Series of Five Cases

Hali¹,

Araqi²,

Marnissi³

et al. 2022

Cureus

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Autoimmune bullous diseases (AIBDs) are a heterogeneous group of diseases characterized by cutaneous and mucosal vesicles, blisters, and erosions. Several factors can trigger this disease, including vaccines; but this entity remains very rare. We hypothesized that vaccination against coronavirus disease 2019 (COVID-19) could trigger an immunological response in genetically predisposed individuals. We report five cases of new-onset autoimmune bullous diseases triggered by the COVID-19 vaccine. Clinical and histopathological examinations confirmed the diagnosis of bullous pemphigoid (BP) in three patients and pemphigus in the other two. According to the French method of imputability, the pharmacovigilance investigation showed an I5B4 causality assessment score for the vaccines, interpreted as highly probable, for all the patients. The diagnosis of vaccine-induced autoimmune bullous dermatosis was highly suspected. One patient's condition improved by dermocorticoids alone, while the other four required oral corticosteroid therapy at 0.5 mg/kg/day, which led to a favorable outcome.

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Bullous pemphigoid and COVID-19 vaccine

Cited by 29 publications

References 5 publications

Bullous Pemphigoid Associated With COVID-19 Vaccines: An Italian Multicentre Study

Bullous Pemphigoid Associated With COVID-19 Vaccines: An Italian Multicentre Study

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

Autoimmune Bullous Dermatosis Following COVID-19 Vaccination: A Series of Five Cases

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