Erythrodermic pityriasis rubra pilaris after SARS‐CoV‐2 vaccination with concomitant COVID‐19 infection

First Onset of Pityriasis Rubra Pilaris following SARS-CoV-2 Booster Vaccination: Case Report and Review of the Literature

“…Of note, PRP represents an exceedingly rare condition, which argues against a chance association, especially considering that since the beginning of COVID-19 vaccination campaigns, several cases of PRP have been detected worldwide. Consequently, following Lladó et al [13], who reported post-COVID vaccination PRP for the first time, 15 further cases including the present patient have now been published [4][5][6][7][8][9][10][11][12][13] (Table 1). Regarding post-COVID-19 infection-related PRP, we identified four previously reported cases, including a case reported by us of a patient who developed PRP after SARS-CoV-2 vaccination and a concomitant breakthrough infection [5,[18][19][20].…”

“…Consequently, following Lladó et al [13], who reported post-COVID vaccination PRP for the first time, 15 further cases including the present patient have now been published [4][5][6][7][8][9][10][11][12][13] (Table 1). Regarding post-COVID-19 infection-related PRP, we identified four previously reported cases, including a case reported by us of a patient who developed PRP after SARS-CoV-2 vaccination and a concomitant breakthrough infection [5,[18][19][20]. Moreover, Margo et al [21] reported PRP-like cases with atypical histopathology such as an interface dermatitis.…”

“…Moreover, Margo et al [21] reported PRP-like cases with atypical histopathology such as an interface dermatitis. Among the published cases of post-COVID vaccination PRP [4][5][6][7][8][9][10][11][12][13], there were 12 (75%) males and only 4 (25%) females (p < 0.05). This predominance in males developing post-COVID vaccination PRP appears to differ from classic adult PRP, which does not show a gender preference.…”

“…The median time of COVID-19-vaccination-related PRP was 9.5 days (range: 3-60 days). The majority of patients received systemic treatment, including corticosteroids, retinoids, and methotrexate [4][5][6][7][8][9][10][11][12][13]. The latter represented first-choice therapies for PRP, even though the evidence for its use in PRP patients is relatively poor.…”

“…Pityriasis rubra pilaris (PRP) is a rare psoriasiform skin disease with an incidence between 1:5000 and 1:50,000 without gender predilection [3]. Including the present case, 16 patients with COVID-19-vaccination-related PRP have been published in the literature [4][5][6][7][8][9][10][11][12][13]. Here, we report a new case of SARS-CoV-2-vaccination-related PRP and provide an analysis of previously reported cases in the medical literature.…”