Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Apr 22;5(2):114-123.
doi: 10.1093/skinhd/vzaf004. eCollection 2025 Apr.

Cutaneous small vessel vasculitis in the COVID-19 era: a systematic review

Katherine Oakley Olson  1 , Siddharth Patel  2 , Prutha Pathak  3 , Lucy Page Kelly  1 , Mc Anto Antony  4 , Mrudula Thiriveedi  2
Affiliations
Review

Cutaneous small vessel vasculitis in the COVID-19 era: a systematic review

Katherine Oakley Olson et al. Skin Health Dis. .

Abstract

Background: Dermatological adverse effects may occur after COVID-19 infection or vaccine administration. Since the beginning of the pandemic, several case reports and systematic reviews have been published on vasculitis associated with both COVID-19 infection and vaccination. Fever, malaise, urticaria, and rash are common symptoms of COVID-19. These symptoms can also occur as adverse reactions to COVID-19 vaccines. However, the occurrence of serious autoimmune reactions due to COVID-19 infection or its vaccine is rare. Cutaneous small vessel vasculitis (CSVV) is an autoimmune disorder that manifests with palpable purpura and petechiae involving the extremities. It results from neutrophilic inflammation within and around dermal vessels and is usually self-limited.

Objective: We provide a thorough systematic review on CSVV occurring in the COVID-19 era.

Methods: We followed the PRISMA 2020 checklist for systematic review, searching PubMed, Google Scholar, Cochrane, and Embase. We included case reports, case series, correspondence articles, and letters to the editor written in English. Characteristics of each were then summarized and analyzed.

Results: 39 cases were included in our review - 27 due to the COVID-19 vaccine and 12 due to COVID-19 infection. Mean age of onset was similar, but mean time to onset was sooner in the vaccination group. Common treatments included systemic steroids, and almost all patients experienced complete recovery with the exception of a few patients in the COVID-19 infection cohort.

Conclusion: While most cases are self-limiting and resolve with no long-term sequalae, the occurrence of more severe reactions appears to be associated with COVID-19 infection rather than with vaccination.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Schematic of the sequential steps in the selection of case reports for the systematic review.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Huang C, Wang Y, Li X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395:497–506. - PMC - PubMed
    1. Galván Casas C, Català A, Carretero Hernández G et al. Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br J Dermatol 2020; 183:71–7. - PMC - PubMed
    1. Wong K, Farooq Alam Shah MU, Khurshid M et al. COVID-19 associated vasculitis: a systematic review of case reports and case series. Ann Med Surg (Lond) 2022; 74:103249. - PMC - PubMed
    1. Cohen SR, Prussick L, Kahn JS et al. Leukocytoclastic vasculitis flare following the COVID-19 vaccine. Int J Dermatol 2021; 60:1032–3. - PMC - PubMed
    1. Bonetto C, Trotta F, Felicetti P et al. Vasculitis as an adverse event following immunization – systematic literature review. Vaccine 2016; 34:6641–51. - PubMed

LinkOut - more resources