Exacerbation of Psoriasis Following COVID-19 Vaccination: Report From a Single Center

Huang, Yi-Wei; Tsai, Tsen‐Fang

doi:10.3389/fmed.2021.812010

Cited by 39 publications

(55 citation statements)

References 31 publications

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“…In the flare group, most patients received mRNA vaccines (28%) [ 8 , 10 – 12 , 28 , 38 – 58 ], with the BioNTech/Pfizer vaccine (20%) reported more often than the Moderna vaccine (7%), followed by the AstraZeneca vaccine (7%) [ 5 , 10 , 12 , 26 , 38 , 50 , 59 ] and the Sinovac vaccine (1%) [ 41 , 60 ]. Flares were most commonly reported following the second vaccine dose (23%) [ 5 , 10 , 12 , 38 – 44 , 49 – 51 , 55 , 56 , 58 ], followed by the first vaccine dose (7%) [ 10 – 12 , 26 , 28 , 38 , 39 , 48 , 50 , 53 , 54 , 59 ], both the first and second doses (2%) [ 38 , 52 ], and the third dose (1%) [ 8 , 39 ]. The onset time in the flare group ranged from 1 day to 90 days.…”

Section: Resultsmentioning

confidence: 99%

New Onset and Exacerbations of Psoriasis Following COVID-19 Vaccines: A Systematic Review

Huang

Wang

et al. 2022

Am J Clin Dermatol

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Background Vaccination has been promoted to control viral transmission in response to the coronavirus disease 2019 (COVID-19) pandemic. Cases of new-onset or exacerbation of psoriasis, an immune-mediated inflammatory disease, were reported following COVID-19 vaccination. However, a comprehensive review examining the association between COVID-19 vaccination and the occurrence or exacerbation of psoriasis has yet to be performed. Objective The aim of this systematic review is to investigate the demographics, clinical variables, and outcomes associated with psoriasis following COVID-19 vaccination. Methods A systematic literature search was conducted using the PubMed, Embase, Web of Science, and Cochrane databases from database inception to April 25, 2022. The review included studies with relevant terms, including ‘psoriasis,’ ‘psoriasis vulgaris,’ ‘guttate psoriasis,’ ‘pustular psoriasis,’ ‘palmoplantar pustulosis,’ ‘psoriatic erythroderma,’ ‘psoriatic arthritis,’ ‘COVID-19,’ and ‘vaccine.’ We included all studies reporting at least one patient who developed new-onset psoriasis or experienced a psoriasis flare following at least one dose of any COVID-19 vaccine. A flare was defined as the worsening of disease conditions after vaccination according to the study by Gregoire et al. The appraisal tool described by Murad et al. was used to assess the quality of case reports and series, whereas the National Institute of Health quality assessment tool was used to assess observational studies. Results The initial search yielded 367 results, including 7 studies reporting new-onset psoriasis, 32 studies reporting psoriasis flares, and 4 studies reporting both. The most commonly observed psoriasis subtype was plaque-type psoriasis. mRNA vaccines, including those produced by Moderna and BioNTech/Pfizer, were frequently associated with subsequent psoriasis episodes. First, second, and third vaccine doses were associated with psoriasis incidents, with the second dose most frequently associated with psoriasis flares. Delayed onset was observed, ranging from 2 to 21 days in the new-onset group and from 1 to 90 days in the flare group. Most patients experienced favorable outcomes, with improvement or resolution occurring within 3 days to 4 months. Conclusions Both new-onset psoriasis and psoriasis flares were reported as cutaneous adverse events following COVID-19 vaccination. Psoriatic patients may require regular follow-up before and after COVID-19 vaccination. Trial Registration Review registration number PROSPERO database: CRD42022304157. Supplementary Information The online version contains supplementary material available at 10.1007/s40257-022-00721-z.

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Section: Resultsmentioning

confidence: 99%

New Onset and Exacerbations of Psoriasis Following COVID-19 Vaccines: A Systematic Review

Huang

Wang

et al. 2022

Am J Clin Dermatol

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“…We found that while < 1% of patients reported psoriatic reactions in association with COVID-19 vaccination, occurring 5.0 days after vaccination, patients with past histories of psoriasis were 56 times more likely to report psoriatic rashes. Psoriatic flares in response to the COVID-19 vaccine were reported in case reports [ 9 – 14 ], and in some larger studies [ 1 , 15 ]. For example, in a study of patients with known history of psoriasis (51 vaccinated and 32 not vaccinated against COVID-19) [ 15 ], vaccinated versus unvaccinated patients were almost eight times more likely to experience psoriasis flares ( p = 0.047), at mean 9.3 ± 4.3 days following vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…Psoriatic flares in response to the COVID-19 vaccine were reported in case reports [ 9 – 14 ], and in some larger studies [ 1 , 15 ]. For example, in a study of patients with known history of psoriasis (51 vaccinated and 32 not vaccinated against COVID-19) [ 15 ], vaccinated versus unvaccinated patients were almost eight times more likely to experience psoriasis flares ( p = 0.047), at mean 9.3 ± 4.3 days following vaccination. In a registry-based study of 414 cases of cutaneous reactions to COVID-19 vaccines [ 1 ], 22.2% (2/9) of patients with history of psoriasis experienced a flare after vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…In a registry-based study of 414 cases of cutaneous reactions to COVID-19 vaccines [ 1 ], 22.2% (2/9) of patients with history of psoriasis experienced a flare after vaccination. It is theorized that mRNA COVID-19 vaccines may activate inflammatory pathways, leading to elevated levels of interleukin-6 and Th-17 cells, resulting in new onset psoriasis or flares [ 15 ]. In a survey of 50 vaccinated psoriatic patients treated with biologics [ 16 ], only one patient reported a psoriasis exacerbation after the vaccine, suggesting that that vaccine-induced flares may be limited in patients receiving immunosuppressants.…”

Section: Discussionmentioning

confidence: 99%

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Curbing COVID-19 Vaccine Hesitancy from a Dermatological Standpoint: Analysis of Cutaneous Reactions in the Vaccine Adverse Event Reporting System (VAERS) Database

et al. 2022

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Objectives Adverse reactions to the COVID-19 vaccines have been of interest since their emergency authorization. Cutaneous manifestations of the vaccines are not well studied. We aimed to characterize cutaneous reactions to the Moderna (mRNA-1273) and the Pfizer-BioNTech (BNT162b2) COVID-19 vaccines on a large, national scale. Methods The Vaccine Adverse Event Reporting System was filtered for cutaneous and hair and nail reactions to the COVID-19 vaccines. Patient demographics and past medical histories, vaccine manufacturer and dosing, symptom timing, reaction location, and patient outcomes were extracted from each report. Results As of December 24, 2021, there were 67,273 cutaneous reactions to all COVID-19 vaccines, with most patients receiving the Moderna (mRNA-1273) or Pfizer-BioNTech (BNT162b2) vaccines. The most common reactions overall were injection-site reaction, urticaria, and papular rash, with injection-site reaction more common after the Moderna (mRNA-1273) vaccine, and all other cutaneous reactions more common after the Pfizer-BioNTech (BNT162b2) vaccine. Patients with past histories of psoriasis, urticaria, and local site reactions to a vaccine were more likely to report these same symptoms after the COVID-19 vaccine. Conclusion Patients should be counseled about these potential dermatologic reactions to the COVID-19 vaccines. Most occur within the first few days after vaccination, and are mild and self-limiting. Patients should therefore be encouraged that it is safe to receive the COVID-19 vaccine from a dermatological perspective.

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“…New onset or exacerbations of psoriasis following vaccination have been described in other different types of vaccines, including influenza, Bacillus Calmette-Guerin, tetanus-diphtheria, and pneumococcal polysaccharide vaccines. 4 Recently, new onset or exacerbations of psoriasis associated with COVID-19 vaccines have been reported, including guttate psoriasis and acute generalized pustular psoriasis. 5 Wei et al 1 reported six patients who experienced an exacerbation of known psoriasis and one patient with new-onset psoriasis following COVID-19 vaccination.…”

Section: Discussionmentioning

confidence: 99%

New Onset of Severe Plaque Psoriasis Following COVID-19 Vaccination: A Case Report

Yong-fang¹,

Zhang²,

Yan³

2022

CCID

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A case of new onset of severe plaque psoriasis following COVID-19 vaccination was reported. A 63-year-old woman presented with multiple plaques for 2 months after the second dose of COVID-19 vaccination. Dermatological examination revealed diffuse erythematous papules and plaques on trunk and limbs. Her lesions responded well to the treatment of secukinumab 150 mg per week. In this case, we presented the potential association between COVID-19 vaccination and the onset of psoriasis. It is essential to recognize the possible adverse events as vaccination against COVID-19 continues worldwide.

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Exacerbation of Psoriasis Following COVID-19 Vaccination: Report From a Single Center

Cited by 39 publications

References 31 publications

New Onset and Exacerbations of Psoriasis Following COVID-19 Vaccines: A Systematic Review

New Onset and Exacerbations of Psoriasis Following COVID-19 Vaccines: A Systematic Review

Curbing COVID-19 Vaccine Hesitancy from a Dermatological Standpoint: Analysis of Cutaneous Reactions in the Vaccine Adverse Event Reporting System (VAERS) Database

New Onset of Severe Plaque Psoriasis Following COVID-19 Vaccination: A Case Report

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