Ixekizumab successfully treated severe pityriasis rubra pilaris after COVID‐19 vaccination

Abstract

Pityriasis rubra pilaris is an inflammatory dermatologic disorder of unknown cause. We report a 67‐year‐old man with Pityriasis rubra pilaris might induced by COVID‐19 vaccination. The patient developed the lesions after the first dose of vaccine and significantly aggravated after the second dose. He had poor effect and liver function impairment developed after acitretin used, but achieved satisfactory efficacy after replacement to ixekizumab, an interleukin‐17A inhibitor.

Pityriasis Rubra Pilaris After Moderna COVID-19 Vaccination: A Case Report and Literature Review

“…16,17 We add to the literature body of PRP as a cutaneous side effect to the COVID-19 vaccine (all cases reported to date are summarized in Table 1). 6,[18][19][20][21][22][23][24][25][26][27][28] The median age of cases is 61 years (range, 31-85 years), with a male-to-female ratio of approximately 2:1. Fifty-five percent (10/18) of patients developed PRP after administration of the first dose of COVID-19 vaccine.…”

Clinical characteristics of patients with pityriasis rubra pilaris following SARS‐CoV‐2 vaccination

“…I would like to briefly add some more information on the clinical characteristics of the previously published COVID-19 vaccine-induced PRP cases. [2][3][4][5][6][7] A broad spectrum of COVID-19 vaccine-induced skin conditions has been reported since the worldwide introduction of SARS-CoV-2 vaccines. 8 Apart from very frequent nonspecific injection site reactions and rare hypersensitivity reactions, chilblain-like lesions, urticarial or moribilliform exanthemas, pityriasis rosea-like, petechial and erythema multiforme-like rashes and autoimmune-mediated conditions (e.g.…”

“…In most patients, systemic treatment consisted of retinoids. [1][2][3][4][5] The latter represented first-choice therapies for PRP, even though the evidence for its use in PRP patients is relatively poor. In current and recent cases, however, interleukin 17 (IL-17), IL-23, and IL-23/12(p40) have also been administered with success in most cases.…”

“…Including the case of Zhang et al, 1 20 COVID-19 vaccine-induced PRP cases have been published so far (Figure 1). [1][2][3][4][5] Unlike classic adult-onset PRP, which is a rare autoinflammatory keratinising disease without gender preference, COVID-19 vaccine-induced PRP appears to be more likely in males (70% of cases, Table 1). By contrast, disease onset in patients with COVID-19 vaccineinduced PRP is around the 60s matching the expected age of disease onset of classic adult PRP.…”

“…COVID-19 vaccine-induced PRP usually occurred about 10 days after vaccination, whereas there was a wide range from 3 to 60 days. [1][2][3][4][5] The vaccines applied were as follows: 8/20 (40%) cases with vector-based vaccines (Vaxzevria, Covishield/AstraZeneca), 8/20 (40%) cases with mRNA-based vaccines (Comirnaty/Pfizer-BioNTech, Spikevax/Moderna) and 4/20 (20%) cases with an inactivated vaccine (CoronaVac/ Sinovac). In most patients, systemic treatment consisted of retinoids.…”