COVID-19 vaccine-induced acute generalized exanthematous pustulosis

Kang, Sung Yoon; Park, So-Young; Kim, Jung-Hyun; Lee, Sang Min; Lee, Sang Pyo

doi:10.3904/kjim.2021.198

Cited by 19 publications

(20 citation statements)

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“…Among the very severe cutaneous ADRs, there is a condition defined by rapid onset of innumerable pustules, called acute generalized exanthematous pustulosis (AGEP), which may be seen as a mimicker of generalized psoriasis pustulosa. Interestingly, both a case of AGEP associated with a viral vector vaccine [79] and a pustular flare of psoriasis associated with an inactivated virus COVID-19 vaccine [80] have been published recently. Another case report was classified as an overlap between AGEP and drug reaction with eosinophilia and systemic symptoms (DRESS) associated with a viral vector vaccine [81].…”

Section: Neutrophilic and Pustular Drug Reactionsmentioning

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: Neutrophilic and Pustular Drug Reactionsmentioning

confidence: 99%

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

et al. 2021

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“…There are a few cases reported in the literature about AGEP after vaccine, both mRNA and viral vector vaccine. The hypothesis is that vaccination could induce the same immunologic response that is seen after SARS-CoV-2 infection; indeed, the same cytokine cascade is released in both cases [2,7,13,14] Our case was the first reported patient with clinical manifestations of cutaneous lupus erythematosus (CLE) arising after the first dose of vaccination. In fact, it is now known that in patients with COVID-19, there is an immune hyper-activation, with increased levels of type I and III IFN, with the release of related cytokines, which in turn lead to the progression of inflammation [15,16].…”

Section: Discussionmentioning

confidence: 91%

Cutaneous Reactions to COVID-19 Vaccines in a Monocentric Study: A Case Series

Cantisani

Chello

Grieco

et al. 2022

JCM

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After coronavirus disease 2019 (COVID-19) caused a global pandemic, vaccines were rapidly developed to control the spread of the virus. Although they were effective in most of the cases at protecting people from becoming seriously ill and being hospitalized, they showed side effects, too. Among other adverse vaccine reactions, cutaneous eruptions following SARS-CoV-2 have been described in the literature, but they are not well-characterized yet. We described the morphology and timing of the spectrum of cutaneous reactions following most of the COVID-19 vaccines available in Italy, which were observed in outpatients referred to our non-invasive diagnostic clinic. Most of these reactions appeared after the second or third COVID-19 vaccine dose (most of them after mRNA COVID-19 vaccines). Our data support that cutaneous reactions to COVID-19 vaccination are generally self-limited; in addition, history of allergic reaction to a specific food, medicine or vaccine should not discourage vaccination in the general population, although patients with immune dysregulation should be accurately selected and monitored. Further research is necessary to better assess the true prevalence and preventive measures of skin reactions to COVID-19 vaccination.

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“…To our knowledge, we report the first case of AZD1222 vaccine‐induced ALEP. Accompanied with the Korean's case, 5 current reports of AZD1222 vaccine‐induced ALEP/AGEP are both women and of Asian descent. While the COVID‐19 vaccinated population is increasing globally, more AZD1222 vaccine‐induced ALEP/AGEP cases may be reported.…”

Section: Figurementioning

confidence: 95%

“…Previous case reports include four cases of AGEP, induced by the measles–mumps–rubella, diphtheria–pertussis–tetanus, and pneumococcal vaccines in an American child; 2 influenza vaccine in a pregnant Japanese woman; 3 tetanus toxoid vaccine in an Indian patient; 4 and AZD1222 vaccine in a Korean woman. 5 …”

Section: Figurementioning

confidence: 99%

Oxford‐AstraZeneca COVID‐19 vaccine‐induced acute localized exanthematous pustulosis

Lin

2021

The Journal of Dermatology

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A 43-year-old woman with medical histories of hyperlipidemia and chronic urticaria received the first dose of the Oxford-AstraZeneca COVID-19 vaccine (AZD1222 vaccine). Two days later, pruritic skin rashes developed at the vaccine injection site of the left arm, and gradually expanded to left upper arm and left chest. On physical examination, the patient had erythematous, edematous plaques with scattered, non-follicular pustules over her left upper arm and left chest (Figure 1a-c). She had a fever on the day after vaccination. She denied any other medication exposure or contact history other than the vaccination. Laboratory test showed a white blood cell count of 11.35 × 10 3 /mm 3 with 89.4% neutrophils. Pathology from skin biopsy revealed subcorneal pustules, basal layer vacuolation, epidermal spongiosis, papillary dermal edema, and superficial perivascular mixed cell infiltration with eosinophils (Figure 1d,e). In addition, numerous intravascular neutrophils were noted (Figure 1f), which may indicate acute chemotaxis. Based on the clinical history, skin presentations,

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COVID-19 vaccine-induced acute generalized exanthematous pustulosis

Cited by 19 publications

References 0 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 Reactions to COVID-19 Vaccines in a Monocentric Study: A Case Series

Oxford‐AstraZeneca COVID‐19 vaccine‐induced acute localized exanthematous pustulosis

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