Fixed drug eruption after Pfizer-BioNTech COVID-19 vaccine: A case report

Lellig, Elodie; Mouton‐Faivre, C.; Abs, Diane; Bursztejn, Anne‐Claire

doi:10.1016/j.jaip.2022.03.033

Cited by 7 publications

(9 citation statements)

References 10 publications

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“…Important questions to include in the history are if the patient had experienced previous lesions in the same area and if any new medications had been started recently. In addition, COVID-19 vaccination status should also be obtained as there have been cases of FDE after the Pfizer-BioNTech COVID-19 vaccination [5].…”

Section: Discussionmentioning

confidence: 99%

Fixed Drug Eruption: An Underrecognized Cutaneous Manifestation of a Drug Reaction in the Primary Care Setting

Shaker¹,

Mehendale²,

Rosa³

2022

Cureus

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Fixed drug eruptions (FDEs) are dermatological manifestations of drug reactions that often occur in the same location upon re-exposure to a drug. They usually appear as erythematous-violaceous, circular patches, but several different variants have been described. They can often present without any associated symptoms, but in some cases, patients may complain of pain and pruritus. The lesions are often underdiagnosed or mistaken for insect bites, urticaria, or erythema multiforme; thus, an effort to bring awareness to this condition is warranted.We present a 33-year-old African-American female who presented to the urgent care presenting with several violaceous patches of varying sizes that started two days ago. The lesions were located on the left shoulder, abdomen, right flank region, and behind the right knee. The lesions were associated with mild pain and pruritus. She believed she was bit by insects but denied seeing any insects at home or participating in any recent outdoor activities. She stated that she had a similar rash in the exact locations five months ago. Upon survey of new medications, she stated that she recently started taking her medications again, which include: hydrochlorothiazide, semaglutide, vitamin D supplement, and ibuprofen. Examination of the skin revealed several black, non-blanching macules with a surrounding ring of erythema on the left shoulder (3 x 3cm), abdomen (4 x 3cm), right popliteal region (3 x 2cm), and right flank region (6 x 7 cm). She was prescribed a medium-dose topical steroid cream to apply to the skin twice a day to decrease the intensity of the inflammatory reaction and thus relieve her symptoms. She was also educated on FDEs and was advised to discontinue Ibuprofen, one of the most commonly implicated drugs in FDEs. Upon returning for a follow-up four weeks later, she noted that she discontinued Ibuprofen, and her cutaneous reactions had fully resolved. This case illustrates the prompt and accurate diagnosis of FDE leading to discontinuation of the offending drug and resolution of symptoms. It also represents the essential questions to ask when suspecting FDE.

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Section: Discussionmentioning

confidence: 99%

Fixed Drug Eruption: An Underrecognized Cutaneous Manifestation of a Drug Reaction in the Primary Care Setting

Shaker¹,

Mehendale²,

Rosa³

2022

Cureus

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“…One potential mechanism is an immune response to the polyethylene glycol excipient of the mRNA vaccine. 8 Similarly, a reaction to ChAdOx1 nCoV‐19 virotopes in adenoviral vectored vaccines 4 has been proposed as a possible mechanism. Notably, polysorbate 80, the vaccine excipient, does not seem to be the culprit allergen.…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenesis of FDE following COVID‐19 vaccination has yet to be determined. One potential mechanism is an immune response to the polyethylene glycol excipient of the mRNA vaccine 8 . Similarly, a reaction to ChAdOx1 nCoV‐19 virotopes in adenoviral vectored vaccines 4 has been proposed as a possible mechanism.…”

Section: Discussionmentioning

confidence: 99%

Generalized fixed drug eruption following Pfizer‐BioNtech COVID‐19 vaccination

Kabir

Feit

Heilman

2022

Clinical Case Reports

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“…To date, only five cases of FDE following COVID-19 vaccination have been reported, 3 following mRNA and 2 after adenoviral vector-based vaccines (Table 1 ) [4][5][6][7][8]. Here, we report a patient with generalized non-bullous fixed drug eruption following vaccination with the mRNA-based Pfizer-BioNTech COVID-19 vaccine.…”

Section: Introductionmentioning

confidence: 86%

“…The pathogenesis of FDE following Covid-19 vaccination has yet to be determined. One potential mechanism is an immune response to the polyethylene glycol (PEG) excipient of the mRNA vaccine [8]. Similarly, a reaction to ChAdOx1 nCoV-19 virotopes in adenoviral vectored vaccines [4] has been proposed as a possible mechanism.…”

Section: Case Presentationmentioning

confidence: 99%