Skin ulcer at the injection site of BNT162b2 mRNA COVID‐19 vaccine

Aoki, Naofumi; Saruta, Y.; Tanaka, Satsuki; NAKAJIMA, Riho; Sano, Hozumi; Sano, Shigetoshi

doi:10.1111/1346-8138.16163

Cited by 7 publications

(8 citation statements)

References 5 publications

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“…With regard to severe injection site reactions after COVID-19 vaccine, purpura fulminans-like lesions that occurred 4 weeks after mRNA-1273 in a 77-year-old woman and skin ulceration that occurred a few days after BNT162b2 in a 79-year-old man have been reported. 8,9 In the prior case, the patient suffered from rheumatoid arthritis, while a diagnosis of Sjögren's disease was reported in our anamnesis. Patients with a pre-existing autoimmune or inflammatory background could be more susceptible to more severe cutaneous reactions owing to a more overreactive immunologic system.…”

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confidence: 74%

Ulcerative injection site reaction after third COVID ‐19 vaccine dose with mRNA ‐1273

Barei

Marletta

Marti‐Marti

et al. 2022

Dermatologic Therapy

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With the advent of vaccines against COronaVIrus Disease 2019 (COVID-19), associated local skin reactions are now largely reported.We herein report the case of a 67-year-old Caucasian woman who presented with a local ulcerative reaction to mRNA-1273 (Spikevax ® ; Moderna) vaccine about 1 month after the injection. The patient had her first two doses of BNT162b2 (Comirnaty ® ; Pfizer-BioNTech) vaccine, 7 and 6 months earlier. Previous vaccinations

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confidence: 74%

Ulcerative injection site reaction after third COVID ‐19 vaccine dose with mRNA ‐1273

Barei

Marletta

Marti‐Marti

et al. 2022

Dermatologic Therapy

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“… 4 Therefore, the SP could be the culprit for immunosuppression that allowed VZV reactivation and its persistence, as well as skin vasculopathy and thrombosis. 12 , 13 Recent literatures revealed that mRNA COVID‐19 vaccination‐associated VZV reactivation preferentially occurred in patients with autoimmune diseases, including rheumatoid arthritis (RA) who were treated with immunosuppressive drugs. 14 , 15 Our patient with RA had been taken prednisolone, tacrolimus, and methotrexate for over a decade, which possibly contributed to prolonged VZV infection after mRNA vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…COVID‐19 infection‐associated VZV reactivation was also described and included multi‐dermatomal herpes zoster (HZ) and atypical HZ mimicking vasculitis, 10,11 suggesting that the suppressive state of T‐cell‐mediated immunity might be the shared condition induced by both COVID‐19 infection and mRNA COVID‐19 vaccine 4 . Therefore, the SP could be the culprit for immunosuppression that allowed VZV reactivation and its persistence, as well as skin vasculopathy and thrombosis 12,13 . Recent literatures revealed that mRNA COVID‐19 vaccination‐associated VZV reactivation preferentially occurred in patients with autoimmune diseases, including rheumatoid arthritis (RA) who were treated with immunosuppressive drugs 14,15 .…”

Section: Discussionmentioning

confidence: 99%

Persistent varicella zoster virus infection following mRNA COVID‐19 vaccination was associated with the presence of encoded spike protein in the lesion

Yamamoto

Kase

Sano

et al. 2022

J Cutaneous Imm & Allergy

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Background Since the campaign of vaccination against COVID‐19 was started, a wide variety of cutaneous adverse effects after vaccination has been documented worldwide. Varicella zoster virus (VZV) reactivation was reportedly the most frequent cutaneous reaction in men after administration of mRNA COVID‐19 vaccines, especially BNT162b2. Aims A patient, who had persistent skin lesions after BNT162b2 vaccination for such a long duration over 3 months, was investigated for VZV virus and any involvement of vaccine‐derived spike protein. Materials & Methods Immunohistochemistry for detection of VZV virus and the spike protein encoded by mRNA COVID‐19 vaccine. PCR analysis for VZV virus. Results The diagnosis of VZV infection was made for these lesions using PCR analyses and immunohistochemistry. Strikingly, the vaccine‐encoded spike protein of the COVID‐19 virus was expressed in the vesicular keratinocytes and endothelial cells in the dermis. Discussion mRNA COVID‐19 vaccination might induce persistent VZV reactivation through perturbing the immune system, although it remained elusive whether the expressed spike protein played a pathogenic role. Conclusion We presented a case of persistent VZV infection following mRNA COVID‐19 vaccination and the presence of spike protein in the affected skin. Further vigilance of the vaccine side effect and investigation for the role of SP is warranted.

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“…In cases where the same sample was used for more than one study, all studies were reviewed to determine the extent to which there may be duplication in the reported outcomes between studies. The full text of selected studies was reviewed, and data on demographics, article type, number of reported cases with cutaneous involvement, vaccine, and rash type (morphology) were extracted from articles texts, tables, figures, and summarized through a descriptive table (Table 1)…”

Section: Methodsmentioning

confidence: 99%

“…), 1 Covishield (Nagrani et al106 ), 1 Moderna (Pesqu e et al154 ), 1 Pfizer (Ricardo et al168 ), 1 Pfizer (Song et al200 ) 69. ), 2 Pfizer (Gruenstein et al109 ), 1 Astrazeneca (Chen et al132 ), 1 Pfizer (Aoki et al144 ) 92. ), 1 Not specified (Dash et al115 ), 1 Pfizer (Holmes et al124 ), 1 Pfizer (Tihy et al130 ) 30.…”

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confidence: 99%

SARS‐CoV‐2 vaccine‐related cutaneous manifestations: a systematic review

et al. 2022

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To date, over 250 million people have been reportedly infected by COVID‐19 disease, which has spread across the globe and led to approximately 5.1 million fatalities. To prevent both COVID‐19 and viral transmission, DNA‐based/RNA‐based vaccines, non‐replicating viral vector vaccines, and inactivated vaccines have been recently developed. However, a precise clinical and histological characterization of SARS‐CoV‐2 vaccine‐related dermatological manifestations is still lacking. A systematic review of 229 articles was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, in order to provide an extensive overview of SARS‐CoV‐2 vaccine‐related skin manifestations. Data on demographics, number of reported cases with cutaneous involvement, vaccine, and rash type (morphology) were extracted from articles and summarized. A total of 5941 SARS‐CoV‐2 vaccine‐related dermatological manifestations were gathered. Local injection‐site reactions were the most frequently observed, followed by rash/unspecified cutaneous eruption, urticarial rashes, angioedema, herpes zoster, morbilliform/maculopapular/erythematous macular eruption, pityriasis rosea and pityriasis rosea‐like eruptions, and other less common dermatological manifestations. Flares of pre‐existing dermatological conditions were also reported. Cutaneous adverse reactions following SARS‐CoV‐2 vaccine administration seem to be heterogeneous, rather infrequent, and not life‐threatening. Vaccinated patients should be monitored for skin manifestations, and dermatological evaluation should be offered, when needed.

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Skin ulcer at the injection site of BNT162b2 mRNA COVID‐19 vaccine

Cited by 7 publications

References 5 publications

Ulcerative injection site reaction after third COVID ‐19 vaccine dose with mRNA ‐1273

Ulcerative injection site reaction after third COVID ‐19 vaccine dose with mRNA ‐1273

Persistent varicella zoster virus infection following mRNA COVID‐19 vaccination was associated with the presence of encoded spike protein in the lesion

SARS‐CoV‐2 vaccine‐related cutaneous manifestations: a systematic review

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