Erythema Multiforme Major following SARS‐CoV‐2 vaccine

Abstract

Erythema multiforme major, an immune‐mediated skin reaction to infections or medications with oral involvement, should be taken into account as a potential side effect of several vaccines, including SARS‐CoV‐2. Correct patient history collection allows prompt recognition and subsequent successful medical management with oral corticosteroids.

Oral Lesions Following Anti-SARS-CoV-2 Vaccination: A Systematic Review

“…Five additional records [ 18 , 19 , 20 , 21 , 22 ], manually retrieved through the reference lists of the eight articles already included in the present systematic review [ 9 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ] and compliant with currently applied eligibility criteria were considered for the current systematic review.…”

“…The study population comprised 11 females and 5 males between 20 and 60 years old, with a mean age of 46.63. Comorbidities and related treatments, reported in 5 cases, were: Leiden factor V mutation in a 31 year old female taking oral contraceptives [ 18 ]; diabetes mellitus and hypertension, treated with amlodipine, teneligliptin, and metformin in a 60-year-old male [ 20 ]; benign pemphigoid of mucous membranes [ 29 ] and celiac disease [ 29 ] in a 55- and a 20-year-old female, respectively; and a 58-year-old female, under sertraline, lorazepam, atorvastatin, metamizole, and penicillin [ 9 ]. Eight participants had a negative history of COVID-19 [ 9 , 18 , 21 , 25 , 29 ], while in one case, the subject became positive for SARS-CoV-2 in the time between the first and second vaccine dose [ 23 ]; in the remaining 7 cases, the previous history of COVID-19 was not specified [ 19 , 20 , 21 , 22 , 24 , 26 , 27 , 28 ].…”

“…Out of the 16 cases diagnosed with oral lesions following anti-SARS-CoV-2 vaccination, 9 cases were diagnosed with oral lesions following the administration of the Pfizer-BioNTech vaccine [ 19 , 24 , 25 , 26 , 28 , 29 ], 2 cases after vaccination with the Moderna vaccine [ 9 , 27 ], and 1 case was described after AstraZeneca [ 18 ], Serum Institute of India [ 20 ], Sinopharm Beijing [ 23 ], and Johnson & Johnson [ 22 ] vaccines, respectively. Oral lesions occurred consequent to the single dose of the Johnson & Johnson vaccine in one case [ 22 ], after the administration of the first dose in a total of 8 cases (5 after the Pfizer-BioNTech [ 19 , 26 , 28 , 29 ], and 1 after the AstraZeneca [ 18 ], Serum Institute of India [ 20 ], and Sinopharm Beijing [ 23 ] vaccines, respectively) and in 7 cases after the administration of thesecond dose (4 after the Pfizer-BioNTech, 2 after Moderna, and 1 after Sinopharm Beijing vaccines, respectively) [ 9 , 24 , 25 , 26 , 27 , 29 ]. In one case [ 21 ], data concerning vaccine type and dose were missing.…”

“…Anti-SARS-CoV-2 vaccines are considered essential tools in managing the COVID-19 pandemic [ 6 ], significantly reducing the risk of viral transmission and infection, preventing severe forms of COVID-19 [ 7 ], and decreasing hospitalization and death rates [ 6 , 8 ]. However, the exceptional circumstances encountered in recent years, due to the global spread of SARS-CoV-2 and related vaccination campaigns, have rekindled interest in the potential risks connected to vaccine administration [ 9 ]. Consequently, it seems particularly relevant to address such an issue to promptly manage adverse events and to improve patient outcomes [ 3 ], especially considering that vaccinations prevent 2 to 3 million yearly deaths from infectious diseases [ 3 ].…”

Virological Characterization of Pigs with Erythema Multiforme

“…Since the SARS-CoV-2 pandemic, numerous cases of erythema multiforme in infected patients have been reported [ 23 , 24 , 29 ]. Erythema multiforme cases were reported after vaccination against the coronavirus, as well as after other vaccinations [ 30 , 31 , 32 ].…”