Three cases of vesiculobullous non‐IgE‐mediated cutaneous reactions to tozinameran (Pfizer‐BioNTech COVID‐19 vaccine)

Juay, Lester; Chandran, Nisha Suyien

doi:10.1111/jdv.17581

Cited by 7 publications

(8 citation statements)

References 8 publications

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“…From the systematic review, we identified 300 articles 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 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ...…”

Section: Resultsunclassified

“…From the systematic review, this report has described various cutaneous manifestations associated with the COVID‐19 vaccine including injection site reactions, 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 which were the most common cutaneous adverse reaction in almost all vaccines, uncommon adverse reactions such as delayed inflammatory reactions to tissue filler, 73 , 127 , 228 , 279 flares of pre‐existing dermatoses (e.g. psoriasis, 103 , 133 , 137 , 141 , 215 , 239 , 248 , 252 , 282 , 312 bullous pemphigoid, 63 , 111 pemphigus vulgaris, 111 , 121 lichen planus, 85 , …”

Section: Discussionmentioning

confidence: 99%

“…From the systematic review, this report has described various cutaneous manifestations associated with the COVID-19 vaccine including injection site reactions, [10][11][12][13][14][15][16][17][18] which were the most common cutaneous adverse reaction in almost all vaccines, uncommon adverse reactions such as delayed inflammatory reactions to tissue filler, 73,127,228,279 flares of pre-existing dermatoses (e.g. psoriasis, 103,133,137,141,215,239,248,252,282,312 bullous pemphigoid, 63,111 pemphigus vulgaris, 111,121 lichen planus, 85,164,245 cutaneous vasculitis, 163 vitiligo 293 and cutaneous lupus erythematosus 156,188,236 ) and viral reactivation (e.g. herpes zoster 74,81,85,92,99,100,102,107,108,113,…”

Section: Discussionmentioning

confidence: 99%

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Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID‐19 vaccination: A systematic review and meta‐analysis

Washrawirul

Triwatcharikorn

Phannajit

et al. 2022

Acad Dermatol Venereol

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Although vaccination is widely accepted as an effective method of preventing and controlling the COVID‐19 pandemic, many people are concerned about possible cutaneous side‐effects, which can delay or prevent them from being vaccinated. The objectives of this systematic review were to assess the global prevalence and clinical manifestations of cutaneous adverse reactions following COVID‐19 vaccination. PubMed and Scopus databases were searched for articles published from 1 January 2019 to 31 December 2021, and reference lists for each selected article were screened. Case reports, case series, observational studies and randomized controlled trials that provided information on cutaneous adverse reactions following COVID‐19 vaccines were included. A total of 300 studies were included in a systematic review of which 32 studies with 946 366 participants were included in the meta‐analysis. The pooled prevalence of cutaneous manifestations following COVID‐19 vaccination was 3.8% (95% CI, 2.7%–5.3%). COVID‐19 vaccines based on the mRNA platform had a higher prevalence than other platforms at 6.9% (95% CI, 3.8%–12.3%). Various cutaneous manifestations have been reported from injection site reactions, which were the most common (72.16%) to uncommon adverse reactions such as delayed inflammatory reactions to tissue filler (0.07%) and flares of pre‐existing dermatoses (0.07%). Severe cutaneous reactions such as anaphylaxis have also been reported, but in rare cases (0.05%). In conclusion, cutaneous adverse reactions are common, especially in those receiving mRNA vaccines. Most reactions are mild and are not contraindications to subsequent vaccination except for anaphylaxis, which rarely occurs. COVID‐19 vaccination may also be associated with flares of pre‐existing dermatoses and delayed inflammatory reactions to tissue filler. Patients with a history of allergies, pre‐existing skin conditions or scheduled for filler injections should receive additional precounselling and monitoring. A better understanding of potential side‐effects may strengthen public confidence in those wary of new vaccine technologies.

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Section: Resultsunclassified

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID‐19 vaccination: A systematic review and meta‐analysis

Washrawirul

Triwatcharikorn

Phannajit

et al. 2022

Acad Dermatol Venereol

View full text Add to dashboard Cite

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“…The reason for exclusion included no discussion of vesicular, papulovesicular, or bullous reactions ( n = 167). Twenty-seven 12 , 13 , 17 - 41 of the 36 articles described nonspecific vesicular, papulovesicular, or bullous reactions, compared to eleven 18 , 24 , 42 - 50 discussing vesicular eruptions in concordance with new-onset or reactivation of the herpes zoster virus. During the screening process, a total of 66 articles discussing other cutaneous manifestations were retrieved from the full-text screening to extract data in tabular formats and were discussed in our narrative review.…”

Section: Resultsmentioning

confidence: 99%

Vesiculobullous and Other Cutaneous Manifestations of COVID-19 Vaccines: a Scoping and Narrative Review

Mahmood

Cyr

et al. 2023

J Cutan Med Surg

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As coronavirus disease (COVID-19) vaccines continue to be administered, dermatologists play a critical role in recognizing and treating the cutaneous manifestations (CM) associated with the vaccines. Adverse cutaneous reactions of COVID-19 vaccines reported in the literature range from common urticarial to rare vesiculobullous reactions. In this study, we performed a (1) scoping review to assess the occurrences of vesicular, papulovesicular, and bullous CMs of COVID-19 vaccines and their respective treatments, and (2) a narrative review discussing other common and uncommon CMs of COVID-19 vaccines. Thirty-six articles were included in the scoping review, and 66 articles in the narrative review. We found that vesicular, papulovesicular, and bullous lesions are infrequent, reported mostly after the first dose of Moderna or Pfizer vaccines. Eleven of the 36 studies reported vesicular reactions consistent with activation or reactivation of the herpes zoster virus. Most vesicular and bullous lesions were self-limited or treated with topical corticosteroids. Other CMs included injection-site, urticarial or morbilliform reactions, vasculitis, toxic epidermal necrolysis, and flaring of or new-onset skin diseases such as psoriasis. Treatments for CMs included topical or oral corticosteroids, antihistamines, or no treatment in self-limited cases. Although most CMs are benign and treatable, the data on the effect of systemic corticosteroids and immunosuppressive therapies on the immunogenicity of COVID-19 vaccines is limited. Some studies report reduced immunogenicity of the vaccines after high-dose corticosteroids use. Physicians may consult local guidelines where available when recommending COVID-19 vaccines to immunosuppressed patients, and when using corticosteroids to manage the CMs of COVID-19 vaccines.

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“…This delayed cutaneous manifestation may be related to the host immune cytokine response rather than true allergies, an observation similar to Juay et al in their 3 cases of vesiculobullous cutaneous reactions to tozinameran. 4 Other vaccines, such the MMR vaccine, have also been previously demonstrated to exacerbate atopic dermatitis via elevated IL-4 levels, disrupting the Th1 and Th2 lymphocytic balance. 5 COVID-19 vaccinations have been reported in association with many cutaneous side effects in many local institution-based studies.…”

Section: Dear Editormentioning

confidence: 99%

Tozinameran (Pfizer-BioNTech COVID-19 vaccine)-induced AGEP-DRESS syndrome

Tay

Lee

Chong

2022

Ann Acad Med Singap

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Three cases of vesiculobullous non‐IgE‐mediated cutaneous reactions to tozinameran (Pfizer‐BioNTech COVID‐19 vaccine)

Abstract: had a slightly higher incidence of facial skin problems than those with oily skin. Changes in the facial microbiome might partly explain the skin problems caused by long-term mask wearing.

Cited by 7 publications

References 8 publications

Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID‐19 vaccination: A systematic review and meta‐analysis

Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID‐19 vaccination: A systematic review and meta‐analysis

Vesiculobullous and Other Cutaneous Manifestations of COVID-19 Vaccines: a Scoping and Narrative Review

Tozinameran (Pfizer-BioNTech COVID-19 vaccine)-induced AGEP-DRESS syndrome

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