Cutaneous lymphocytic vasculitis after administration of
            <scp>COVID</scp>
            ‐19
            <scp>mRNA</scp>
            vaccine

Vassallo, Camilla; Boveri, Emanuela; Brazzelli, Valeria; Rampino, Teresa; Bruno, Raffaele; Bonometti, Arturo; Gregorini, Marilena

doi:10.1111/dth.15076

Cited by 18 publications

(11 citation statements)

References 8 publications

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“…Previous reported cases of post COVID‐19 vaccine associated reactivated or new onset LCV or IgA vasculitis were seen with either mRNA or inactivated SARS‐CoV‐2 vaccines but none with recombinant corona virus vaccine (Table S1 ). 4 , 7 , 8 , 9 , 10 , 11 In both of our cases, a temporal association between vaccination and LCV could be established with a probable causal relationship in case 1 and definite relationship in case 2. Historically, first LCV episode in case 2 occurred 7 days after vaccination, which was mild with rash limited to ankles, resolving within a week and without any constitutional symptoms.…”

Section: Discussionsupporting

confidence: 53%

“…Dermatological manifestations similar to reported in COVID‐19 infection are now being increasingly seen associated with COVID‐19 vaccination. New onset or reactivation of cutaneous and IgA vasculitis has been observed in handful of cases associated with either messenger ribonucleic acid (mRNA) or inactivated SARS‐CoV‐2 vaccines but none with ChAdOx1 nCoV‐19 corona virus vaccine (recombinant) 4,7–11 . ChAdOx1 nCoV‐19 corona virus vaccine (recombinant) is replication‐deficient chimpanzee adenovirus vector vaccine that encodes SARS‐CoV‐2 Spike glycoprotein which is being extensively used in Indian subcontinent, European, and South American nations.…”

Section: Introductionmentioning

confidence: 99%

“…New onset or reactivation of cutaneous and IgA vasculitis has been observed in handful of cases associated with either messenger ribonucleic acid (mRNA) or inactivated SARS-CoV-2 vaccines but none with ChAdOx1 nCoV-19 corona virus vaccine (recombinant). 4,[7][8][9][10][11] ChAdOx1 nCoV-19 corona virus vaccine (recombinant) is replicationdeficient chimpanzee adenovirus vector vaccine that encodes SARS-CoV-2 Spike glycoprotein which is being extensively used in Indian subcontinent, European, and South American nations. We report two patients who developed leukocytoclastic vasculitis (LCV) following corona virus vaccine (recombinant) and its management.…”

Section: Introductionmentioning

confidence: 99%

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Leukocytoclastic vasculitis as a cutaneous manifestation of ChAdOx1 nCoV‐19 corona virus vaccine (recombinant)

Sandhu

Bhatnagar

Kumar

et al. 2021

Dermatologic Therapy

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With the present COVID‐19 vaccination drive across the world, adverse skin reactions post COVID‐19 vaccine is expected. Majority of these reactions seen were transient or local injection site reactions. However, as the larger population is being vaccinated, certain uncommon dermatological presentations including leukocytoclastic vasculitis, pityriasis rosea, and exacerbation of pre‐existing autoimmune diseases are now being reported. Among all the COVID‐19 vaccines, most of these reactions are seen with messenger ribonucleic acid‐based Pfizer/BioNTech (BNT162b2) and Moderna (mRNA‐1273) vaccine. We report two cases of leukocytoclastic vasculitis following ChAdOx1 nCoV‐19 corona virus vaccine (recombinant) that bring out potential new dermatological manifestations of recombinant corona virus vaccine being administered across the European, South American, and Asian countries. It is important for all health care workers and patients to be aware of the corona virus vaccine associated adverse cutaneous reactions.

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Leukocytoclastic vasculitis as a cutaneous manifestation of ChAdOx1 nCoV‐19 corona virus vaccine (recombinant)

Sandhu

Bhatnagar

Kumar

et al. 2021

Dermatologic Therapy

View full text Add to dashboard Cite

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“… 41 Only three cases have been reported so far. 7 , 8 , 9 Kharkar et al 8 reported a 31‐year‐old woman with painful purpuric lesions on her legs with pedal edema, one day after her second dose of inactivated viral vaccine (COVAXIN®; Bharat Biotech, Hyderabad, India). RT‐PCR for SARS‐CoV‐2 infection was negative.…”

Section: Resultsmentioning

confidence: 99%

“…Only one had cryoglobulinemia. 7 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 36 , 37 Nastro et al 21 reported an 84‐year‐old woman, with history of chronic kidney disease and depressive disorder, developed burning pain on the distal part of right leg and foot, followed by ipsilateral multiple non‐confluent purpuric papules and vesicles few hours after she received the first dose of Pfizer‐BioNTech COVID‐19 vaccine. PCR of a skin swab for varicella‐zoster virus (VZV) resulted positive, and VZV IgM and IgG antibodies were positive.…”

Section: Resultsmentioning

confidence: 99%

SARS‐CoV‐2 vaccination‐induced cutaneous vasculitis: Report of two new cases and literature review

Abdelmaksoud

Wollina

Temiz

et al. 2022

Dermatologic Therapy

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Currently the most powerful tool in combating the COVID‐19 pandemic is vaccination against SARS‐CoV‐2. A growing percentage of the world's population is being vaccinated. Various vaccines are worldwide on the market. Several adverse reactions have been reported as a part of post‐marketing surveillance of COVID‐19 vaccines. Among the possible adverse events, cutaneous vasculitis has occasionally been reported. We present a narrative review on cutaneous vasculitis related to COVID‐19‐vaccination to summarize clinical findings, histopathology, treatment and outcome. We searched for “COVID vaccine”, “COVID vaccination” AND “cutaneous vasculitis” in PUBMED. Articles in English have been selected, from inception to December 2021, and analyzed for patient's characteristics, type of vaccine, time of appearance of cutaneous vasculitis and clinico‐histopathologic type. Treatment and outcome have also been considered in this narrative review. Two new unpublished cases of ours were added. Cutaneous vasculitis is a rare adverse event to COVID‐19 vaccination. It has been observed with mRNA and adenovirus‐vector vaccines. IgA vasculitis, lymphocytic and ANCA‐associated vasculitis, leukocytoclastic and urticarial vasculitis have been reported. This adverse event can occur after first or second shot. Most cases run a mild to moderate course. Cornerstone of medical treatment are systemic corticosteroids. Complete remission could be achieved in most patients. Vasculitis may not be considered as a contraindication of vaccination, being uncommonly reported and shows a favorable prognosis. The benefit of the vaccination remains high especially for immunocompromised patients. COVID‐vaccine induced vasculitis is important in the differential diagnosis of purpuric and vasculitis disorders.

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COVID-19 Vasculitis and vasculopathy-Distinct immunopathology emerging from the close juxtaposition of Type II Pneumocytes and Pulmonary Endothelial Cells

et al. 2022

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The SARS-CoV-2 virus ACE-2 receptor utilization for cellular entry and the defined ACE-2 receptor role in cardiovascular medicine hinted at dysregulated endothelial function or even direct viral endotheliitis as the key driver of severe COVID-19 vascular immunopathology including reports of vasculitis. In this article, we critically review COVID-19 immunopathology from the vasculitis perspective and highlight the non-infectious nature of vascular endothelial involvement in severe COVID-19. Whilst COVID-19 lung disease pathological changes included juxta-capillary and vascular macrophage and lymphocytic infiltration typical of vasculitis, we review the evidence reflecting that such “vasculitis” reflects an extension of pneumonic inflammatory pathology to encompass these thin-walled vessels. Definitive, extrapulmonary clinically discernible vasculitis including cutaneous and cardiac vasculitis also emerged- namely a dysregulated interferon expression or “COVID toes” and an ill-defined systemic Kawasaki-like disease. These two latter genuine vasculitis pathologies were not associated with severe COVID-19 pneumonia. This was distinct from cutaneous vasculitis in severe COVID-19 that demonstrated pauci-immune infiltrates and prominent immunothrombosis that appears to represent a novel immunothrombotic vasculitis mimic contributed to by RNAaemia or potentially diffuse pulmonary venous tree thrombosis with systemic embolization with small arteriolar territory occlusion, although the latter remains unproven. Herein, we also performed a systematic literature review of COVID-19 vasculitis and reports of post-SARS-CoV-2 vaccination related vasculitis with respect to the commonly classified pre-COVID vasculitis groupings. Across the vasculitis spectrum, we noted that Goodpasture’s syndrome was rarely linked to natural SARS-CoV-2 infection but not vaccines. Both the genuine vasculitis in the COVID-19 era and the proposed vasculitis mimic should advance the understanding of both pulmonary and systemic vascular immunopathology.

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Cutaneous lymphocytic vasculitis after administration of COVID ‐19 mRNA vaccine

Cited by 18 publications

References 8 publications

Leukocytoclastic vasculitis as a cutaneous manifestation of ChAdOx1 nCoV‐19 corona virus vaccine (recombinant)

Leukocytoclastic vasculitis as a cutaneous manifestation of ChAdOx1 nCoV‐19 corona virus vaccine (recombinant)

SARS‐CoV‐2 vaccination‐induced cutaneous vasculitis: Report of two new cases and literature review

COVID-19 Vasculitis and vasculopathy-Distinct immunopathology emerging from the close juxtaposition of Type II Pneumocytes and Pulmonary Endothelial Cells

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