Linear IgA bullous dermatosis following Oxford AstraZeneca COVID‐19 vaccine

Abstract

A case of linear IgA bullous dermatosis developing 3 days after the second dose of Oxford AstraZeneca COVID‐19 vaccine in an adult patient, suggesting a possible causal association. It is worth keeping in mind that COVID‐19 vaccination could induce immune‐mediated bullous disease in susceptible people.

Eosinophil‐rich linear IgA bullous dermatosis induced by mRNA COVID‐19 booster vaccine

“…While no cases of LABD have been reported with COVID‐19 infection, there are two reports of LABD being triggered by the recombinant Oxford‐AstraZeneca and mRNA Pfizer‐BioNTech COVID‐19 vaccines. In both these cases, eosinophils were seen in the infiltrate, although not as dense as seen in our patient 16 , 17 In these reports, a 61‐year‐old male developed LABD 3 days after the second dose of the Oxford‐AstraZeneca COVID‐19 vaccine and was treated with oral prednisolone with improvement, 16 while a 71‐year‐old male developed LABD 3 days after the second dose of the Pfizer‐BioNTech COVID‐19 vaccine and was treated with topical corticosteroids with improvement. 17 …”

“…While bullous pemphigoid (BP) has been the most commonly reported vaccine-related AIBD, linear IgA bullous dermatosis (LABD) has also been reported in the setting of both the recombinant Oxford-AstraZeneca and messenger RNA (mRNA) Pfizer-BioNTech COVID-19 vaccines. 16,17 Here, we present a case of LABD triggered by the mRNA Moderna COVID-19 vaccine booster with histopathological features resembling BP that required confirmation with direct immunofluorescence (DIF) and indirect immunofluorescence (IIF) studies for accurate diagnosis.…”

Autoimmune mucocutaneous blistering diseases after SARS-Cov-2 vaccination: A Case report of Pemphigus Vulgaris and a literature review

“…A total of 195 articles was retrieved and after the screening, 20 articles were finally included for the review. A total of 35 AIBDs cases (including our case) were found, as shown in Table 1 [7] , [8] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] . The sub-epithelial diseases were the most frequent, accounting for 28 cases (80.0%), specifically 26 cases of BP (74.3%) and 2 case of LABD (5.7%).…”

Toxic epidermal necrolysis-like linear IgA bullous dermatosis after third Moderna COVID-19 vaccine in the setting of oral terbinafine

“…Of note, the patient received the Oxford AstraZeneca vector vaccine, which is not an mRNA vaccine. 6 Various mechanisms exist that could potentially explain our patient's heightened immunogenicity following her COVID-19 vaccination. One possible mechanism lies within the role of certain vaccine adjuvants.…”

“…To date, there have been only 2 other reported cases of LABD potentially associated with COVID-19 vaccination. 5,6 Coto-Segura et al 5 reported on a 71year-old man, who developed small vesiculobullae, some in a rosette-like pattern, over the thighs 3 days after receiving a second booster of the Pfizer COVID-19 vaccine. The patient was not taking any concomitant drugs at the time of his Pfizer COVID-19 vaccine booster.…”