Research Article
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Cutaneous diseases developed following BNT162b2 and CoronaVac vaccines

Year 2024, Volume: 41 Issue: 1, 65 - 72, 29.03.2024

Fidan Yegin Bener

Abstract

Although the safety of severe acute respiratory syndrome coronavirus 2 vaccines was demonstrated in clinical trials, some adverse events were also reported after their routine use. In this study, the delayed cutaneous reactions that developed after BNT162b2 and CoronaVac vaccines are reported. The data of 25 patients who were followed up for late cutaneous adverse reactions after vaccination were compiled retrospectively. Cases with a history of infection or drug use were not included. The causality assessment of the cases was measured with the Naranjo algorithm. A total of 48% of the patients were female and 52% were male. The diseases detected were urticaria, leukocytoclastic vasculitis (LCV), purpuric rash, Sweet’s syndrome (SS), lichenoid drug eruption (LDE), psoriasis, acneiform eruption and pigmented purpuric dermatosis (PPD). The trigger was BNT162b2 in 72% of the cases, and CoronaVac in 28%. The lesions appeared after the first dose in 64% of cases. The mean lesion onset duration was 9±5.8 days. According to Naranjo algorithm, all cases were in the “probable” range. No recurrence was detected after the repeat doses in any case whose trigger was BNT162b2. In PPD, LDE, and psoriasis cases whose trigger was CoronaVac, the symptoms increased after the booster doses, while there was no recurrence in other cases. Except for the cases of PPD, LDE, and psoriasis, very little therapeutic intervention was required and was self-limited in a short time. Although post-vaccine cutaneous reactions were heterogeneous, the most common late cutaneous reaction following BNT162b2 was found to be urticaria. Exacerbation of PPD, LDE, and psoriasis following CoronaVac repeat dose supported the causal association. Other cases who had repeated doses tolerated the vaccines very well.

Keywords

Sweet’s syndrome psoriasis BioNTech BNT162b2 mRNA vaccine COVID-19 Sinovac CoronaVac vaccine adverse effect

References

  • Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157-160.
  • COVID-19 Aşı Çalışmaları ve Uygulamaları. In: Gürbüz S,Aydın S, Çöl M. Yeni Koronavirüs Pandemisi Sürecinde Türkiye’de COVID-19 Aşılaması ve Bağışıklama Hizmetlerinin Durumu. Türk Tabipleri Birliği. Mayıs 2021:45-47.
  • Triwatcharikorn J, Puaratana-Arunkon T, Punyaratabandhu P, Mongkolpathumrat P, Palapinyo S, Buranapraditkul S, et al. Acute urticaria alone after CoronaVac COVID-19 vaccination should not be a contraindication for revaccination. Clin Exp Dermatol. 2021;47(4):735-738.
  • Hatziantoniou S, Maltezou HC, Tsakris A, Poland GA, Anastassopoulou C. Anaphylactic reactions to mRNA COVID-19 vaccines: A call for further study. Vaccine. 2021;39(19):2605-2607.
  • Al Kaabi N, Zhang Y, Xia S, Yang Y, Al Qahtani MM, Abdulrazzaq N, et al. Effect of 2 Inactivated SARS-CoV-2 Vaccines on Symptomatic COVID-19 Infection in Adults: A Randomized Clinical Trial. JAMA. 2021;326(1):35-45.
  • Bellinato F, Maurelli M, Gisondi P, Girolomoni G. Cutaneous Adverse Reactions Associated with SARS-CoV-2 Vaccines. J Clin Med. 2021;10(22):5344.
  • Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature. Clin Cosmet Investig Dermatol. 2022;15:2369-2382.
  • Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239-45.
  • Niebel D, Novak N, Wilhelmi J, Ziob J, Wilsmann-Theis D, Bieber T, et al. Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective. Vaccines (Basel). 2021;9(9):944.
  • Labella M, Céspedes JA, Doña I, Shamji MH, Agache I, Mayorga C, et al. The value of the basophil activation test in the evaluation of patients reporting allergic reactions to the BNT162b2 mRNA COVID-19 vaccine. Allergy. 2021;10.1111/all.15148.
  • Cabanillas B, Akdis CA, Novak N. COVID-19 vaccine anaphylaxis: IgE, complement or what else? A reply to: “COVID-19 vaccine anaphylaxis: PEG or not?”. Allergy. 2021;76(6):1938-1940.
  • Eyerich K, Eyerich S. Immune response patterns in non-communicable inflammatory skin diseases. J Eur Acad Dermatol Venereol. 2018;32(5):692-703.
  • Qaderi K, Golezar MH, Mardani A, Mallah MA, Moradi B, Kavoussi H, Shamsabadi A, Golezar S. Cutaneous adverse reactions of COVID-19 vaccines: A systematic review. Dermatol Ther. 2022;35(5):e15391.
  • Niebel D, Wenzel J, Wilsmann-Theis D, Ziob J, Wilhelmi J, Braegelmann C. Single-Center Clinico-Pathological Case Study of 19 Patients with Cutaneous Adverse Reactions Following COVID-19 Vaccines. Dermatopathology (Basel). 2021;8(4):463-476.
  • Tihy M, Menzinger S, André R, Laffitte E, Toutous-Trellu L, Kaya G. Clinicopathological features of cutaneous reactions after mRNA-based COVID-19 vaccines. J Eur Acad Dermatol Venereol. 2021;35(12):2456-2461.
  • McMahon DE, Amerson E, Rosenbach M, Lipoff JB, Moustafa D, Tyagi A, et al. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases. J Am Acad Dermatol. 2021;85(1):46-55.
  • Farinazzo E, Ponis G, Zelin E, Errichetti E, Stinco G, Pinzani C, et al. Cutaneous adverse reactions after m-RNA COVID-19 vaccine: early reports from Northeast Italy. J Eur Acad Dermatol Venereol. 2021;35(9):e548-e551.
  • Ireifej B, Weingarten M, Dhamrah U, Weingarten M, Hadi S. Leukocytoclastic Vasculitic Rash Following Second Dose of Moderna COVID-19 Vaccine. J Investig Med High Impact Case Rep. 2022;10:23247096211066283.
  • Sandhu S, Bhatnagar A, Kumar H, Dixit PK, Paliwal G, Suhag DK, et al. Leukocytoclastic vasculitis as a cutaneous manifestation of ChAdOx1 nCoV-19 corona virus vaccine (recombinant). Dermatol Ther. 2021;34(6):e15141.
  • Bostan E, Gulseren D, Gokoz O. New-onset leukocytoclastic vasculitis after COVID-19 vaccine. Int J Dermatol. 2021;60(10):1305-1306.
  • Abdelmaksoud A, Wollina U, Temiz SA, Hasan A. SARS-CoV-2 Vaccination-Induced Cutaneous Vasculitis: Report of two new cases and literature Review. Dermatol Ther. 2022:e15458.
  • Baffa ME, Maglie R, Giovannozzi N, Montefusco F, Senatore S, Massi D, et al. Sweet Syndrome Following SARS-CoV2 Vaccination. Vaccines (Basel). 2021;9(11):1212.
  • Klepfisch L, Facile A, Godeneche J, Skowron F. Syndrome de Sweet histiocytique après le vaccin à ARNm contre la COVID-19. Annales de Dermatologie et de Vénéréologie-FMC. 2021;1(8):A274-A275.
  • Majid I, Mearaj S. Sweet syndrome after Oxford-AstraZeneca COVID-19 vaccine (AZD1222) in an elderly female. Dermatol Ther. 2021;34(6):e15146.
  • Darrigade AS, Théophile H, Sanchez-Pena P, Milpied B, Colbert M, Pedeboscq S, et al. Sweet syndrome induced by SARS-CoV-2 Pfizer-BioNTech mRNA vaccine. Allergy. 2021;76(10):3194-3196.
  • Walker DC, Cohen PR. Trimethoprim-sulfamethoxazole-associated acute febrile neutrophilic dermatosis: case report and review of drug-induced Sweet's syndrome. J Am Acad Dermatol. 1996;34(5 Pt 2):918-23.
  • Correia C, Fernandes S, Soares-de-Almeida L, Filipe P. Exuberant lichenoid eruption after Oxford-AstraZeneca COVID-19 vaccine: a singular case. J Eur Acad Dermatol Venereol. 2022;36(4):e268-e270.
  • Durmaz K, Aykut Temiz S, Metin Z, Dursun R, Abdelmaksoud A. Allergic and cutaneous reactions following inactivated SARS-CoV-2 vaccine (CoronaVac®) in healthcare workers. Clin Exp Dermatol. 2022;47(1):171-173.
  • Satılmış Kaya A, Cemşitoğlu N, Adışen E, Erdem Ö. Lichen planus after CoronaVac: a rare complication of vaccines. J Eur Acad Dermatol Venereol. 2022;36(5):e326-e327.
  • Zagaria O, Villani A, Ruggiero A, Potestio L, Fabbrocini G, Gallo L. New-onset lichen planus arising after COVID-19 vaccination. Dermatol Ther. 2022;11:e15374.
  • Weyers W, Metze D. Histopathology of drug eruptions – general criteria, common patterns, and differential diagnosis. Dermatol Pract Concept. 2011;1(1):33-47.
  • Onsun N, Kaya G, Işık BG, Güneş B. A generalized pustular psoriasis flare after CoronaVac COVID-19 vaccination: Case report. Health Promot Perspect. 2021;11(2):261-262.
  • Lehmann M, Schorno P, Hunger RE, Heidemeyer K, Feldmeyer L, Yawalkar N. New onset of mainly guttate psoriasis after COVID-19 vaccination: a case report. J Eur Acad Dermatol Venereol. 2021;35(11):e752-e755.
  • Sotiriou E, Tsentemeidou A, Bakirtzi K, Lallas A, Ioannides D, Vakirlis E. Psoriasis exacerbation after COVID-19 vaccination: a report of 14 cases from a single centre. J Eur Acad Dermatol Venereol. 2021;35(12):e857-e859.
  • Rerknimitr P, Puaratanaarunkon T, Wongtada C, Wittayabusarakam N, Krithin S, Paitoonpong L, et al. Cutaneous adverse reactions from 35,229 doses of Sinovac and AstraZeneca COVID-19 vaccination: a prospective cohort study in healthcare workers. J Eur Acad Dermatol Venereol. 2022;36(3):e158-e161.
  • Falkenhain-López D, Gutiérrez-Collar C, Arroyo-Andrés J, Gallego-Gutiérrez I, Rodríguez-Peralto JL, Sánchez-Velázquez A. Widespread purpura annularis telangiectodes following mRNA SARS-CoV-2 vaccine. J Eur Acad Dermatol Venereol. 2021;35(11):e719-e721.
  • Atak MF, Farabi B, Kalelioglu MB, Rao BK. Pigmented purpuric dermatosis after BNT162B2 mRNA COVID-19 vaccine administration. J Cosmet Dermatol. 2022;21(2):435-437.

Year 2024, Volume: 41 Issue: 1, 65 - 72, 29.03.2024

Fidan Yegin Bener

Abstract

References

  • Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157-160.
  • COVID-19 Aşı Çalışmaları ve Uygulamaları. In: Gürbüz S,Aydın S, Çöl M. Yeni Koronavirüs Pandemisi Sürecinde Türkiye’de COVID-19 Aşılaması ve Bağışıklama Hizmetlerinin Durumu. Türk Tabipleri Birliği. Mayıs 2021:45-47.
  • Triwatcharikorn J, Puaratana-Arunkon T, Punyaratabandhu P, Mongkolpathumrat P, Palapinyo S, Buranapraditkul S, et al. Acute urticaria alone after CoronaVac COVID-19 vaccination should not be a contraindication for revaccination. Clin Exp Dermatol. 2021;47(4):735-738.
  • Hatziantoniou S, Maltezou HC, Tsakris A, Poland GA, Anastassopoulou C. Anaphylactic reactions to mRNA COVID-19 vaccines: A call for further study. Vaccine. 2021;39(19):2605-2607.
  • Al Kaabi N, Zhang Y, Xia S, Yang Y, Al Qahtani MM, Abdulrazzaq N, et al. Effect of 2 Inactivated SARS-CoV-2 Vaccines on Symptomatic COVID-19 Infection in Adults: A Randomized Clinical Trial. JAMA. 2021;326(1):35-45.
  • Bellinato F, Maurelli M, Gisondi P, Girolomoni G. Cutaneous Adverse Reactions Associated with SARS-CoV-2 Vaccines. J Clin Med. 2021;10(22):5344.
  • Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature. Clin Cosmet Investig Dermatol. 2022;15:2369-2382.
  • Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239-45.
  • Niebel D, Novak N, Wilhelmi J, Ziob J, Wilsmann-Theis D, Bieber T, et al. Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective. Vaccines (Basel). 2021;9(9):944.
  • Labella M, Céspedes JA, Doña I, Shamji MH, Agache I, Mayorga C, et al. The value of the basophil activation test in the evaluation of patients reporting allergic reactions to the BNT162b2 mRNA COVID-19 vaccine. Allergy. 2021;10.1111/all.15148.
  • Cabanillas B, Akdis CA, Novak N. COVID-19 vaccine anaphylaxis: IgE, complement or what else? A reply to: “COVID-19 vaccine anaphylaxis: PEG or not?”. Allergy. 2021;76(6):1938-1940.
  • Eyerich K, Eyerich S. Immune response patterns in non-communicable inflammatory skin diseases. J Eur Acad Dermatol Venereol. 2018;32(5):692-703.
  • Qaderi K, Golezar MH, Mardani A, Mallah MA, Moradi B, Kavoussi H, Shamsabadi A, Golezar S. Cutaneous adverse reactions of COVID-19 vaccines: A systematic review. Dermatol Ther. 2022;35(5):e15391.
  • Niebel D, Wenzel J, Wilsmann-Theis D, Ziob J, Wilhelmi J, Braegelmann C. Single-Center Clinico-Pathological Case Study of 19 Patients with Cutaneous Adverse Reactions Following COVID-19 Vaccines. Dermatopathology (Basel). 2021;8(4):463-476.
  • Tihy M, Menzinger S, André R, Laffitte E, Toutous-Trellu L, Kaya G. Clinicopathological features of cutaneous reactions after mRNA-based COVID-19 vaccines. J Eur Acad Dermatol Venereol. 2021;35(12):2456-2461.
  • McMahon DE, Amerson E, Rosenbach M, Lipoff JB, Moustafa D, Tyagi A, et al. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases. J Am Acad Dermatol. 2021;85(1):46-55.
  • Farinazzo E, Ponis G, Zelin E, Errichetti E, Stinco G, Pinzani C, et al. Cutaneous adverse reactions after m-RNA COVID-19 vaccine: early reports from Northeast Italy. J Eur Acad Dermatol Venereol. 2021;35(9):e548-e551.
  • Ireifej B, Weingarten M, Dhamrah U, Weingarten M, Hadi S. Leukocytoclastic Vasculitic Rash Following Second Dose of Moderna COVID-19 Vaccine. J Investig Med High Impact Case Rep. 2022;10:23247096211066283.
  • Sandhu S, Bhatnagar A, Kumar H, Dixit PK, Paliwal G, Suhag DK, et al. Leukocytoclastic vasculitis as a cutaneous manifestation of ChAdOx1 nCoV-19 corona virus vaccine (recombinant). Dermatol Ther. 2021;34(6):e15141.
  • Bostan E, Gulseren D, Gokoz O. New-onset leukocytoclastic vasculitis after COVID-19 vaccine. Int J Dermatol. 2021;60(10):1305-1306.
  • Abdelmaksoud A, Wollina U, Temiz SA, Hasan A. SARS-CoV-2 Vaccination-Induced Cutaneous Vasculitis: Report of two new cases and literature Review. Dermatol Ther. 2022:e15458.
  • Baffa ME, Maglie R, Giovannozzi N, Montefusco F, Senatore S, Massi D, et al. Sweet Syndrome Following SARS-CoV2 Vaccination. Vaccines (Basel). 2021;9(11):1212.
  • Klepfisch L, Facile A, Godeneche J, Skowron F. Syndrome de Sweet histiocytique après le vaccin à ARNm contre la COVID-19. Annales de Dermatologie et de Vénéréologie-FMC. 2021;1(8):A274-A275.
  • Majid I, Mearaj S. Sweet syndrome after Oxford-AstraZeneca COVID-19 vaccine (AZD1222) in an elderly female. Dermatol Ther. 2021;34(6):e15146.
  • Darrigade AS, Théophile H, Sanchez-Pena P, Milpied B, Colbert M, Pedeboscq S, et al. Sweet syndrome induced by SARS-CoV-2 Pfizer-BioNTech mRNA vaccine. Allergy. 2021;76(10):3194-3196.
  • Walker DC, Cohen PR. Trimethoprim-sulfamethoxazole-associated acute febrile neutrophilic dermatosis: case report and review of drug-induced Sweet's syndrome. J Am Acad Dermatol. 1996;34(5 Pt 2):918-23.
  • Correia C, Fernandes S, Soares-de-Almeida L, Filipe P. Exuberant lichenoid eruption after Oxford-AstraZeneca COVID-19 vaccine: a singular case. J Eur Acad Dermatol Venereol. 2022;36(4):e268-e270.
  • Durmaz K, Aykut Temiz S, Metin Z, Dursun R, Abdelmaksoud A. Allergic and cutaneous reactions following inactivated SARS-CoV-2 vaccine (CoronaVac®) in healthcare workers. Clin Exp Dermatol. 2022;47(1):171-173.
  • Satılmış Kaya A, Cemşitoğlu N, Adışen E, Erdem Ö. Lichen planus after CoronaVac: a rare complication of vaccines. J Eur Acad Dermatol Venereol. 2022;36(5):e326-e327.
  • Zagaria O, Villani A, Ruggiero A, Potestio L, Fabbrocini G, Gallo L. New-onset lichen planus arising after COVID-19 vaccination. Dermatol Ther. 2022;11:e15374.
  • Weyers W, Metze D. Histopathology of drug eruptions – general criteria, common patterns, and differential diagnosis. Dermatol Pract Concept. 2011;1(1):33-47.
  • Onsun N, Kaya G, Işık BG, Güneş B. A generalized pustular psoriasis flare after CoronaVac COVID-19 vaccination: Case report. Health Promot Perspect. 2021;11(2):261-262.
  • Lehmann M, Schorno P, Hunger RE, Heidemeyer K, Feldmeyer L, Yawalkar N. New onset of mainly guttate psoriasis after COVID-19 vaccination: a case report. J Eur Acad Dermatol Venereol. 2021;35(11):e752-e755.
  • Sotiriou E, Tsentemeidou A, Bakirtzi K, Lallas A, Ioannides D, Vakirlis E. Psoriasis exacerbation after COVID-19 vaccination: a report of 14 cases from a single centre. J Eur Acad Dermatol Venereol. 2021;35(12):e857-e859.
  • Rerknimitr P, Puaratanaarunkon T, Wongtada C, Wittayabusarakam N, Krithin S, Paitoonpong L, et al. Cutaneous adverse reactions from 35,229 doses of Sinovac and AstraZeneca COVID-19 vaccination: a prospective cohort study in healthcare workers. J Eur Acad Dermatol Venereol. 2022;36(3):e158-e161.
  • Falkenhain-López D, Gutiérrez-Collar C, Arroyo-Andrés J, Gallego-Gutiérrez I, Rodríguez-Peralto JL, Sánchez-Velázquez A. Widespread purpura annularis telangiectodes following mRNA SARS-CoV-2 vaccine. J Eur Acad Dermatol Venereol. 2021;35(11):e719-e721.
  • Atak MF, Farabi B, Kalelioglu MB, Rao BK. Pigmented purpuric dermatosis after BNT162B2 mRNA COVID-19 vaccine administration. J Cosmet Dermatol. 2022;21(2):435-437.
There are 37 citations in total.

Details

Primary Language English
Subjects Dermatology
Journal Section Research Article
Authors

Fidan Yegin Bener 0000-0002-4390-7070

Publication Date March 29, 2024
Submission Date July 10, 2023
Acceptance Date March 21, 2024
Published in Issue Year 2024 Volume: 41 Issue: 1

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APA Yegin Bener, F. (2024). Cutaneous diseases developed following BNT162b2 and CoronaVac vaccines. Journal of Experimental and Clinical Medicine, 41(1), 65-72.
AMA Yegin Bener F. Cutaneous diseases developed following BNT162b2 and CoronaVac vaccines. J. Exp. Clin. Med. March 2024;41(1):65-72.
Chicago Yegin Bener, Fidan. “Cutaneous Diseases Developed Following BNT162b2 and CoronaVac Vaccines”. Journal of Experimental and Clinical Medicine 41, no. 1 (March 2024): 65-72.
EndNote Yegin Bener F (March 1, 2024) Cutaneous diseases developed following BNT162b2 and CoronaVac vaccines. Journal of Experimental and Clinical Medicine 41 1 65–72.
IEEE F. Yegin Bener, “Cutaneous diseases developed following BNT162b2 and CoronaVac vaccines”, J. Exp. Clin. Med., vol. 41, no. 1, pp. 65–72, 2024.
ISNAD Yegin Bener, Fidan. “Cutaneous Diseases Developed Following BNT162b2 and CoronaVac Vaccines”. Journal of Experimental and Clinical Medicine 41/1 (March 2024), 65-72.
JAMA Yegin Bener F. Cutaneous diseases developed following BNT162b2 and CoronaVac vaccines. J. Exp. Clin. Med. 2024;41:65–72.
MLA Yegin Bener, Fidan. “Cutaneous Diseases Developed Following BNT162b2 and CoronaVac Vaccines”. Journal of Experimental and Clinical Medicine, vol. 41, no. 1, 2024, pp. 65-72.
Vancouver Yegin Bener F. Cutaneous diseases developed following BNT162b2 and CoronaVac vaccines. J. Exp. Clin. Med. 2024;41(1):65-72.
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