Cutaneous manifestations following COVID-19 vaccination: A report of 25 cases

Abstract

Various adverse effects particularly cutaneous manifestations associated with different COVID-19 vaccines have been observed in practice. The aim of our study was to evaluate all patients who presented to our tertiary center with skin manifestations following COVID-19 vaccines injection from September to December 2021. All patients with skin manifestation within 30 days or less following COVID-19 vaccination were enrolled in our case-series. All cases included in our study were diagnosed based on clinical and/or histopathological evaluation and all other possible differential diagnoses were ruled out. Twenty-five individuals including 16 (64%) males and 9 (36%) females with the mean age of 47 ± 17.62 years (range 18-91) were enrolled in our study. Twenty-two (88%) patients developed lesions after Sinopharm vaccine injection and 3 (12%) cases manifested lesions after the AstraZeneca vaccine. Six (24%) patients developed new-onset lichen planus (LP) and 1 (4%) patient manifested LP flare-up. Two (8%) individuals developed psoriasis and 1 (4%) case showed psoriasis exacerbation. One (4%) patient developed new-onset pemphigus vulgaris (PV) and 1 (4%) case experienced a flare of PV lesions. One (4%) patient manifested pityriasis lichenoides et varioliformis acuta (PLEVA) flare-up. Other new-onset cases were as follows: toxic epidermal necrolysis (TEN) (n = 1, 4%), bullous pemphigoid (BP) (n = 2, 8%), alopecia areata (AA) (n = 2, 8%), pytriasis rosea (n = 1, 4%), herpes zoster (n = 1, 4%), cutaneous small vessel vasculitis (n = 1, 4%), erythema multiform (EM) and urticaria (n = 3, 12%), and morphea (n = 1, 4%). Physicians should be aware of the possible side effects especially cutaneous manifestations associated with COVID-19 vaccines.

Keywords: COVID-19; COVID-19 vaccine; astrazeneca; side-effect; sinopharm.

FIGURE 1

(A–C) A 34‐year‐old male patient with a past medical history of psoriasis and chronic urticaria controlled with cetirizine experienced generalized erythematous scaly papules and urticarial lesions following Sinopharm vaccine

FIGURE 2

(A–C) A 49‐year‐old female without any past medical history that developed lichen planus following Sinopharm vaccine

FIGURE 3

(A–D) A 74‐year‐old male with scalp and beard area alopecia following Sinopharm vaccine

FIGURE 4

(A–C) A 85‐year‐old male with bullous pemphigoid after Sinopharm vaccine

FIGURE 5

(A–C) A 45‐year‐old male without any past medical history that developed cutaneous small vessel vasculitis after Sinopharm vaccine