Alopecia areata after COVID-19 vaccination

Abstract

The coronavirus disease 2019 (COVID-19) vaccines are authorized for use in numerous countries worldwide. Several cutaneous findings are reported after severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) vaccination. Here, we report the case of a patient with a rapid onset of alopecia areata immediately after receiving the second dose of the COVID-19 vaccine. Alopecia areata is a common autoimmune disease leading to non-scarring hair loss. Among the many cutaneous adverse effects reported after the anti-SARS-COV2 vaccination, no episodes of alopecia areata have been described to date. In this paper, we report the first case of alopecia areata after COVID-19 vaccination described in the literature with a revision of cases of alopecia areata reported after other types of vaccination. Although the significance of these skin reactions is not yet known, further studies will certainly clarify whether the development of alopecia areata or other forms of immune-mediated reactions could represent a positive prognostic factor regarding immune protection from SARS-CoV-2.

Keywords: Alopecia areata; COVID-19; Trichoscopy; Vaccine.

Fig. 1. Multiple patches of alopecia areata involving the temporo-parietal (A), occipital (B), and vertex areas (C). Patches of alopecia areata involving the beard (D). Written informed consent for publication of this image was obtained from the patient.

Fig. 2. Trichoscopic pictures showing yellow dots, black dots, dystrophic hairs, and vellus hairs performed at the periphery (A) and center (B–D) of alopecia patches (×10–×50; FotoFinder Dermoscope; Germany). Written informed consent for publication of this image was obtained from the patient.