COVID-19 Vaccines and the Skin

Sun, Qisi; Fathy, Ramie; McMahon, Devon E.; Freeman, Esther E.

doi:10.1016/j.det.2021.05.016

Cited by 108 publications

(76 citation statements)

References 40 publications

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“…However, similar to SARS-CoV-2 infection, it remains unclear whether there is a real causal relationship between chilblain-like lesions and the vaccine. 8,10,15,28,42 Furthermore, McMahon et al 28 observed a case of mRNA vaccine-induced erythromelalgiaan uncommon condition that has been noted in response to other vaccines as well, such as those for influenza and hepatitis B.…”

Section: Functional Angiopathiesmentioning

confidence: 99%

“…Notably, these reactions are more commonly observed in individuals younger than 60 years. 8,10,15,42 Type I and type IV hypersensitivity reactions Type I (immediate) Immunoglobulin E-mediated (type I) allergic reactions to antiviral vaccines are usually not caused by the viral antigen but by vaccine ingredients, such as egg proteins, gelatine and formaldehyde. In the case of COVID-19 vaccines, polyethylene glycols (PEGs) and cross-reactive polysorbate 80 have been blamed to be the causal factors for immediate hypersensitive/allergic reactions, such as urticaria, angio-oedema and even anaphylaxis.…”

Section: Early Unspecific Injection-site Reactionsmentioning

confidence: 99%

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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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Section: Functional Angiopathiesmentioning

confidence: 99%

Section: Early Unspecific Injection-site 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

View full text Add to dashboard Cite

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“…Singular case reports and case series about cutaneous side effects of these agents are available [80,91,92]. A group from the USA has published a comprehensive overview of cutaneous ADRs to various vaccines that deserves mention [93].…”

Section: Granulomatous and Fibrogenic 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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“…On the other hand, most of the adverse skin manifestations expected after vaccination against COVID-19 are mild and are related to the presence of acute signs such as erythema and local edema in the area surrounding the inoculation; these are not usually of clinical concern since they are common to other vaccines, and usually persist for a maximum of three days until their complete resolution without health intervention [61]. The oral cavity can be altered by COVID-19 disease.…”

Section: Vaccinated Without Infectionmentioning

confidence: 99%

Identification, Mechanism, and Treatment of Skin Lesions in COVID-19: A Review

Fernández-Lázaro

Garrosa

2021

Viruses

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Coronavirus disease 2019 (COVID-19) is a multisystem disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), that primarily causes respiratory symptoms. However, an increasing number of cutaneous manifestations associated with this disease have been reported. The aim of this study is to analyze the scientific literature on cutaneous manifestations associated with SARS-CoV-2 by means of a narrative literature review until June 2021. The search was conducted in the following electronic databases: Medline (PubMed), SciELO, and Cochrane Library Plus. The most common cutaneous manifestations in patients with COVID-19 are vesicular eruptions, petechial/purpuric rashes, acral lesions, liveoid lesions, urticarial rash, and maculopapular-erythematous rash. These manifestations may be the first presenting symptoms of SARS-CoV-2 infection, as is the case with acral lesions, vesicular eruptions, and urticaria. In relation to severity, the presence of liveoid lesions may be associated with a more severe course of the disease. Treatment used for dermatological lesions includes therapy with anticoagulants, corticosteroids, and antihistamines. Knowledge of the dermatologic manifestations associated with SARS-CoV-2 contributes to the diagnosis of COVID-19 in patients with skin lesions associated with respiratory symptoms or in asymptomatic patients. In addition, understanding the dermatologic lesions associated with COVID-19 could be useful to establish a personalized care plan.

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COVID-19 Vaccines and the Skin

Cited by 108 publications

References 40 publications

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

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

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

Identification, Mechanism, and Treatment of Skin Lesions in COVID-19: A Review

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