ABSTRACT
In response to the COVID-19 pandemic, over 89 million doses of coronavirus vaccines have been administered so far in the UK. An increasing number of mucocutaneous reactions are being seen as a result of the vaccines. These reactions can vary, from pruritus to urticaria and angio-oedema (Robinson LB, Fu X, Hashimoto D et al. Incidence of cutaneous reactions after messenger RNA COVID-19 vaccines. JAMA Dermatol 2021;157: 1000-2). Its recognition is important, as a small proportion of patients can develop potentially life-threatening conditions. Furthermore, initial reactions can have consequences on subsequent vaccine doses. We carried out a retrospective review of patients referred to our dermatology service over a 4-month period (June-October 2021) and identified those with suspected mucocutaneous reactions secondary to COVID-19 vaccines. Six patients were identified, three woman and three men, with a mean age of 56 years. Mucocutaneous reactions seen included: extensive parapsoriasis, widespread blistering rash, urticaria, angio-oedema, lichenoid papular eruption and erythema multiforme. Three reactions occurred after the Pfizer vaccine, two after the AstraZeneca and one was not specified. Two patients were advised not to have further doses. The incidence of cutaneous reactions to the COVID-19 vaccines is estimated to be 4% (McMahon DE, Amerson E, Rosenbach M et al. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: a registry-based study of 414 cases. J Am Acad Dermatol 2021;85: 46-55). It is important to increase awareness and knowledge of these reactions, to allow appropriate management, and informed discussion regarding the safety of further doses.