ABSTRACT
Introduction: Cutaneous manifestations such as morbilliform rashes, lichen planus, and local injection site patches have been recently published in case reports to occur within days of receiving the coronavirus disease 2019 (COVID-19) vaccine. The most common drug eruptions have been noted to be delayed hypersensitivity reactions. Objective: To spotlight a vaccine drug eruption case in a patient with a long history of the autoimmune condition, psoriasis vulgaris. Case Presentation: A 51-year-old Caucasian female presented with pruritic and erythematous rashes covering her back, abdomen, pelvis, and both upper extremities emerging one week after receiving the Pfizer BioNTech mRNA vaccine. The rashes worsened, rapidly spreading toward the lower extremities within five days after her second dose. The patient was diagnosed with psoriasiform spongiotic dermatitis compatible with a drug eruption and began loratadine and clobetasol cream treatment and phototherapy. Conclusion: With limited published data available on skin reactions to the COVID-19 vaccine, our case report is among one of the first presentations to describe a morbilliform rash induced by a Pfizer BioNTech mRNA drug-eruption. Although this is a rare case, we may expect more reported drug eruptions to be documented as mass vaccinations continue to be dispensed across the globe. Physicians must be prepared to accurately diagnose and treat dermatologic conditions on patients with and without pre-existing illnesses. © 2022 THE AUTHORS. Published by the National Society for Cutaneous Medicine.