Generalized erythrodermic psoriasis triggered by vaccination against severe acute respiratory syndrome Coronavirus 2

Tran, Tong Ba; Pham, Nhi Thi Uyen; Phan, Huy Ngoc; Nguyen, Hieu

doi:10.1111/dth.15464

Cited by 16 publications

(19 citation statements)

References 10 publications

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“…Normal LFT and electrolytes. COVID-19 PCR(−), blood culture(−), HAV(−), HBV(−), HCV(−), HIV(−), syphilis(−) TCS CsA 3 mg/kg QD, UVB 3 times/wk for 3 mo, TCS, OAC Resolved (3 mo) NR Tran et al 2022 [ 58 ] Vietnam 30 F 15-y history of chronic plaque psoriasis (PASI < 10) Pfizer (2nd) 7 d Pause all anti-psoriatic treatments due to fear of adverse drug–vaccine interactions after vaccination Fatigue, fever, malaise, and poor oral intake lasting for several days. Generalized erythematous patches with marked desquamation (BSA > 75%) Normal BR except severe hypocalcemia and a mildly elevated eosinophil count SEC, traditional herbal remedies, TCS, Vit D OAC 25 mg QD Improved (2 wk) None Vietnam 45 F Moderate stable plaque psoriasis for more than 20 y (PASI 10) Pfizer (2nd) 7 d Denied using any systemic meds Diffusely erythematous and scaly, marked edema of lower extremities (BSA 90%) Normal BR TCS/TCAL NR NR None PsA Spinelli et al 2022 [ 43 ] Italy 47 F PsA mRNA vaccine (2nd) 18 d NR III PIP arthritis NR Without tx None Resolved (10 d) None 58 F PsA mRNA vaccine (2nd) 3 d NR Inflammatory back and neck pain NR TNF-αi NSAID (once) …”

Section: Resultsmentioning

confidence: 99%

“…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%

“…Two cases of new-onset psoriasis involving body surface areas (BSAs) of 30% and 60% were reported after the second AstraZeneca and Moderna vaccine doses, respectively [ 5 , 9 ]. The severity of psoriasis flares was reported by 15 studies according to either PASI or BSA [ 8 – 10 , 12 , 26 , 28 , 40 , 41 , 46 , 50 , 55 , 58 , 61 ], ranging from PASI 2.1 to 48.6 and BSA 2–95%.…”

Section: Resultsmentioning

confidence: 99%

“…No patients presented with elevated anti-streptolysin O (ASLO) titers, and a throat culture performed in the case reported by Pesqué et al [ 28 ] was negative. Twelve studies including 14 patients in the flare group documented laboratory findings [ 11 , 28 , 41 , 42 , 53 – 58 , 60 , 61 ]. A slightly elevated CRP level was reported for a 51-year-old man who experienced a plaque psoriasis flare after receiving the second dose of the BioNTech/Pfizer vaccine [ 41 ].…”

Section: Resultsmentioning

confidence: 99%

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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%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

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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“…The pathophysiologic link between psoriasis and PRP suggests common pathways. Notably, flare-ups or a new onset of pustular psoriasis have been observed in the context of COVID-19 vaccination [22,23]. Interleukin 23 (IL-23)-and IL-17-directed treatment regimens, which are very successfully used for psoriasis patients, might also be beneficial for patients with PRP [24][25][26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

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

Gambichler¹,

Scheel²,

Arafat³

et al. 2022

Dermato

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There is increasing evidence of adverse events associated with the use of COVID-19 vaccines. Here, we report a case of the SARS-CoV-2-vaccination-related onset of pityriasis rubra pilaris (PRP) and provide an analysis of previously reported cases in the medical literature. A 67-year-old male presented with a 1-year history of histopathologically proven PRP that first developed 14 days after receiving a COVID-19 booster vaccination. Skin symptoms improved under ustekinumab medication after unsuccessful previous treatment approaches using systemic corticosteroids, brodalumab, and risankizumab. Among the published cases of post-COVID vaccination PRP, 12 (75%) males and 4 (25%) females were reported. The median age of the reported patients was 59 years. In 10 out of 16 patients (62.5%), PRP was diagnosed after the first vaccine dose, in 4 (25%) after the second dose, and in 2 of 15 patients (12.5%) after the third dose. The median time between COVID-19 vaccination and the onset of PRP was 9.5 days (range: 3–60 days). The majority of patients required systemic treatment, including systemic retinoids and methotrexate. PRP might be a rare adverse event after COVID-19 vaccination, particularly affecting older males. Even though most reported patients with COVID-19-vaccination-related PRP could be successfully treated with PRP standard medications, therapy refractory cases may also occur. Thus, clinicians must be aware of this rare but potentially severe complication.

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An unusual acute erythrodermic rash

Naworski,

Shedd,

Shedd

et al. 2024

JACEP Open

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Coalescing, erythematous, desquamating patches, and plaques as seen anteriorly. scalded skin syndrome, as well as Steven Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS).Cyclosporine and methotrexate are first-line pharmacologic treatment options for erythrodermic psoriasis, and the majority of patients achieve remission within 2-4 months. 3 CONFLICT OF INTEREST STATEMENT

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Generalized erythrodermic psoriasis triggered by vaccination against severe acute respiratory syndrome Coronavirus 2

Cited by 16 publications

References 10 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

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

An unusual acute erythrodermic rash

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