Psoriasis exacerbation after
            <scp>COVID</scp>
            ‐19 vaccination in high‐risk group: How to manage it?

Kabbani, Mariam; Poskin, Maud; Benhadou, Farida

doi:10.1111/dth.15368

Cited by 7 publications

(8 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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%

“…To control psoriasis flares following vaccination, dosage titration of prior treatments was documented in three cases (1%) [ 8 , 26 , 44 ]. Six cases (2%) were maintained at the dosage used for prior treatments [ 26 , 28 , 38 , 43 ], and 19 patients (7%) were treated with add-on medications, such as topical agents, phototherapy, or systemic therapies, including topical emollients, betamethasone, clobetasol propionate, calcipotriol/betamethasone combination, isoconazole and diflucortolone valerate, systemic methylprednisolone, methotrexate, cyclosporine, apremilast, infliximab, tildrakizumab, and brodalumab [ 5 , 12 , 26 , 38 , 46 , 52 , 53 , 59 ]. Eighteen cases (6%) changed their treatment regimens completely to achieve disease control [ 11 , 12 , 38 , 43 , 45 , 54 – 58 , 60 , 61 ].…”

Section: Resultsmentioning

confidence: 99%

“…Six patients (2%) who experienced psoriasis flares following the first vaccine administration did not experience another flare episode after the second vaccine administration [ 28 , 48 , 50 ]. However, psoriasis flares after both vaccine doses were reported in seven patients (3%) [ 5 , 9 , 38 , 41 , 50 , 52 ]. No patients died from new-onset psoriasis or psoriasis flares following COVID-19 vaccination in all included studies.…”

Section: Resultsmentioning

confidence: 99%

“…Generally, a gradual tapering of systemic corticosteroids was recommended for psoriatic patients [ 84 ]. In our study, systemic corticosteroids were administered in eight cases during the acute phase of psoriasis (including plaque, palmoplantar pustulosis, severe pustular, generalized pustular, and erythrodermic psoriasis and PsA) [ 11 , 38 , 44 , 52 , 61 ]. Intravenous methylprednisolone administered daily at 40–60 mg and oral prednisolone administered daily at 25–60 mg, in addition to other systemic agents, were used for disease control.…”

Section: Discussionmentioning

confidence: 99%

See 3 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

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

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

View full text Add to dashboard Cite

show abstract

“…After excluding 26 articles, 33 articles were retrieved, assessed and included in this review [ Table 1 ]. [ 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 ] Risk of bias was then assessed and presented in Supplementary Tables 1 and 2 .…”

Section: Resultsmentioning

confidence: 99%

New-Onset and Exacerbation of Psoriasis following COVID-19 Vaccination: A Systematic Review of Case Reports and Case Series

Arifin,

Hengky,

Widjaja

et al. 2023

Indian Journal of Dermatology

View full text Add to dashboard Cite

Introduction: Although uncommon, several cases of new-onset and exacerbation of psoriasis have been reported after coronavirus disease 2019 (COVID-19) vaccination. This study aims to systematically review reports regarding new-onset and exacerbation of psoriasis to identify features related to that condition following COVID-19 vaccination. Materials and Methods: Three databases were utilised, namely, PubMed, Google Scholar, and EBSCOHost to search for literature published until June 2022. We used the following MeSH terms: “psoriasis,” “exacerbation,” “induced psoriasis,” and “COVID-19 vaccination.” The included literature must report the case/(s) of psoriasis exacerbation in previously-in-remission or induced psoriasis in individuals receiving any dose of COVID-19 vaccines regardless of the type. Results: Among 33 selected studies, an overall mean age was 57.52 ± 15.92 years. Female (n = 40; 54.8%) was more frequently reported than male (n = 33; 45.2%). In terms of vaccine types, Pfizer is the most commonly reported (49 cases; 67.1%), followed by Astra-Zeneca (13 cases; 17.8%), Moderna (10 cases; 13.7%), and CoronaVac (1 case; 1.4%). The onset of psoriasis after receiving the COVID-19 Vaccines was varied, ranging from 1 to 90 days (Mean ± SD: 15.75 ± 18.22). Plaque psoriasis was most commonly reported, followed by pustular, guttate and other types of psoriasis. Reported cases were frequently treated with topical steroids and monoclonal antibodies monotherapy. Conclusions: Although the cases of new-onset and exacerbation of psoriasis after COVID-19 vaccination is quite scarce, the possibility of occurrence should be acknowledged and managed properly; and patients should be informed, particularly ones with history of psoriasis without discouraging patients to take vaccine.

show abstract

A real-world prospective cohort study of immunogenicity and reactogenicity of ChAdOx1-S[recombinant] among patients with immune-mediated dermatological diseases

Chanprapaph¹,

Seree-aphinan²,

Rattanakaemakorn³

et al. 2022

British Journal of Dermatology

View full text Add to dashboard Cite

Background Immunogenicity and reactogenicity of COVID-19 vaccines have been established in various groups of immunosuppressed patients; however, studies involving patients with immune-mediated dermatological diseases (IMDDs) are scarce. Objectives To investigate the influence of IMDDs on the development of SARS-CoV-2-specific immunity and side-effects following ChAdOx1-S[recombinant] vaccination. Methods This prospective cohort study included 127 patients with IMDDs and 97 participants without immune-mediated diseases who received ChAdOx1-S[recombinant]. SARS-CoV-2-specific immunity and side-effect profiles were assessed at 1 month postvaccination and compared between groups. Immunological (primary) outcomes were the percentages of participants who tested positive for neutralizing antibodies [seroconversion rate (SR)] and those who developed T-cell-mediated immunity demonstrated by an interferon-γ-releasing assay (IGRA) [positive IGRA rate (+IGRA)]. Reactogenicity-related (secondary) outcomes were the unsolicited adverse reactions and worsening of IMDD activity reflected by the uptitration of immunosuppressants during and within 1 month of vaccination. Results Overall, the SR for the IMDD group was similar to that of participants without immune-mediated conditions (75·6 vs. 84·5, P = 0·101), whereas + IGRA was lower (72·4 vs. 88·7, P = 0·003). Reactogenicity was similar between groups. No severe adverse reaction was reported. By stratifying the participants in the IMDD group according to individual disease, the immunogenicity of the vaccine was lowest in patients with autoimmune bullous diseases (AIBD) (SR 64·5%, +IGRA 62·9%) and highest in patients with psoriasis (SR 87·7%, +IGRA 80·7%). The reverse trend was found for vaccine-related reactions. Immunosuppressants were uptitrated in 15·8% of cases; 75% of these were patients with AIBD. Conclusions Among participants with IMDDs, ChAdOx1-S[recombinant] showed good immunogenicity among patients with psoriasis, but demonstrated lower levels of immunogenicity for patients with AIBD. Some patients, especially patients with AIBD, should be closely monitored as they may require treatment escalation within 1 month postvaccination.

show abstract

Psoriasis exacerbation after COVID ‐19 vaccination in high‐risk group: How to manage it?

Cited by 7 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

New-Onset and Exacerbation of Psoriasis following COVID-19 Vaccination: A Systematic Review of Case Reports and Case Series

A real-world prospective cohort study of immunogenicity and reactogenicity of ChAdOx1-S[recombinant] among patients with immune-mediated dermatological diseases

Contact Info

Product

Resources

About