ABSTRACT
Leukocytoclastic vasculitis after the BNT162b2 vaccine and ChAdOxl nCoV-19 Corona Virus vaccine [recombinant] has been observed. Herein, we report two cases of leukocytoclastic vasculitis that developed after the ChAdOxl-S [recombinant] vaccination. A 61-year-old and a 52-year-old woman presented with pruritic purpuric macules and papules on both lower legs. The patients had been vaccinated with the ChAdOxl-S [recombinant] vaccine. The histopathological analyses were consistent with a diagnosis of leukocytoclastic vasculitis. They were treated with oral prednisolone and improved within 1 month of treatment. We assume that the rash had arisen from the deposition of spike protein at the skin tissue induced by the viral vector of the COVID-19 vaccine or hyperimmune responses by excipients present in vaccine preparations. To our knowledge, our cases would be the first Korean cases of leukocytoclastic vasculitis after the ChAdOxl-S [recombinant] vaccination. © 2022 Korean Dermatological Association. All rights reserved.
ABSTRACT
BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, various adverse skin reactions to long-term mask wearing have been reported. AIM: To assess the clinical features of mask-induced dermatoses and to recommend prevention and treatment options. METHODS: From April to August 2020, questionnaires including topics such as demographic information, pre-existing skin disorders, reported mask-related symptoms, daily mask-wearing duration and frequency, types of masks used and whether the participant was a healthcare worker, were distributed to patients in 12 hospitals. Dermatologists assessed skin lesions, confirmed diagnosis and recorded treatments. RESULTS: Itchiness was the most frequent symptom, mostly affecting the cheeks. The most common skin disease was new-onset contact dermatitis (33.94%), followed by new-onset acne (16.97%) and worsening of pre-existing acne (16.97%). Daily wearing of masks was significantly (P = 0.02) associated with new-onset contact dermatitis. More than half of patients with pre-existing skin problems experienced disease worsening while wearing masks. Longer duration of wearing (> 6 h/day, P = 0.04) and use of cotton masks (P < 0.001) significantly increased acne flare-up. Healthcare workers had a higher incidence of skin disease. Skin lesions were generally mild and well tolerated with topical treatment. The study had some limitations: the effect of seasonal characteristics and other risk factors were not assessed, and the patients were visiting dermatological clinics and had interest in their skin status, thus, there may have been selection bias. CONCLUSION: Mask-induced/-triggered dermatoses contribute to increase the dermatological burden during the pandemic.