Dermatopathology of COVID-19 infection and vaccination

Abstract

Background Many peculiar skin changes have been described in relation to both coronavirus disease 2019 (COVID-19) infection and vaccination. Objective This paper provides an overview of these dermatologic manifestations, focusing on their dermatopathological appearances. Results Most COVID-19 patients develop variegated maculopapular eruptions with a combination of histological patterns commonly including keratinocyte apoptosis and eosinophilia. Urticaria-like lesions often show a combination of spongiotic and lichenoid patterns and are more frequent in individuals with severe disease. Vesicular lesions can be disseminated; in some cases, they become pustular and in others show dyskeratosis and a peculiar form of ballooning. Some patients develop vesicular Grover disease on the trunk. Young patients with a strong immunological response can eliminate the virus easily but may develop chilblains as a consequence of the high interferon response. Conversely, older individuals with immunosenescence and a tendency toward hypercoagulability can present livedoid and ischemic areas. Regarding COVID-19 vaccination, hypersensitivity reactions are most frequent, including “COVID-arm.” Nonetheless, a combination of local and systemic cutaneous manifestations (reactogenicity) is commonly seen. Histopathologically, lichenoid and spongiotic changes and a variable number of eosinophils are typical of rashes characterized by papules and plaques. Other dermatological side effects of COVID-19 vaccination include lesions mimicking well-defined dermatoses such as lichen planus or bullous pemphigoid and triggering of collagenous diseases. Conclusion Well-characterized skin manifestations of coronavirus disease 2019 (COVID-19) include chilblains, livedo necrotic lesions, vesicular eruptions, urticarial lesions, and maculopapular eruptions. Hypersensitivity reactions are common after SARS-CoV‑2 mRNA vaccination. Vaccine reactions may also mimic other dermatosis such as bullous pemphigoid or lichen planus, stimulate herpes reactivation, or trigger the development of autoimmune diseases.

Diagnosis and Treatment of Post-Radiofrequency Synovial Knee Fistula: Case Report

“…6 Fourth, although some dermatosis secondary to vaccine reactions has been reported, no guidelines recommended against this procedure. 16,17 Lastly, preventive measures to mitigate such complications include using smaller diameter cannulas, using meticulous technique, ensuring postoperative immobilization and protection, as well as prompt identification and management of complications.…”

Acquired idiopathic generalized anhidrosis after novel coronavirus (SARS‐CoV‐2) infection

“…Various cutaneous disorders associated with SARS-CoV-2 infection have been reported recently. 3 The most characteristic cutaneous disease of SARS-CoV-2 infection is chilblains, livedoid and necrotic lesions, vascular eruptions, urticaria-like eruptions, and maculopapular eruption. occur in young patients whose innate immune responses are strong, whereas aged-patients with immune senescence present livedoid and ischemic lesions.…”

“…occur in young patients whose innate immune responses are strong, whereas aged-patients with immune senescence present livedoid and ischemic lesions. 3 In addition, SARS-CoV-2 infection and its vaccination induce hyperstimulation of host immune system, leading to the induction of flares or even development of de novo autoimmune diseases. 2,3 Indeed, there are five cases AIGA triggered by COVID-19 vaccination.…”

“…3 In addition, SARS-CoV-2 infection and its vaccination induce hyperstimulation of host immune system, leading to the induction of flares or even development of de novo autoimmune diseases. 2,3 Indeed, there are five cases AIGA triggered by COVID-19 vaccination. 4 Collectively, SARS-CoV-2 infection could develop de novo autoimmune cutaneous disease de novo.…”

Grover’s disease — current understanding of transient and persistent acantholytic dermatosis

“…В 1976 г. R.S. Simon [5] В недавних обзорах литературы описаны случаи дебюта болезни Гровера на фоне протекающей инфекции SARS-CoV-2 или после нее [11][12][13].…”