COVID-19 vaccines and filler reactions: Should it be considered as a concern?

BACKGROUND: Any implant or external material used in the body tissues can potentially be followed by autoimmune or inflammatory reactions. With the global vaccination program against COVID-19, the reports of tissue filler reactions would be increasingly demonstrated. AIM: To summarize the data regarding COVID vaccination and filler reactions. METHOD: We reviewed the existing data in this regard through searching on PubMed, Google Scholar and Scopus. All of the relevant papers published until March 2022, which we could access to their fulltexts were included. RESULTS: Here, we summarized the data regarding COVID-19 vaccination and filler reactions and discussed its etiopathogenesis, management, and importance. CONCLUSION: Although the end of pandemic was announced, the necessity of continuing COVI-D19 vaccination in future mandates gathering data regarding safety of vaccines.

COVID vaccine recommendations in dermatologic patients on immunosuppressive agents: Lessons learned from pandemic.

Since SARS-CoV2 vaccines were approved without enough long-term monitoring due to emergent situations, some issues have been raised about timing and protocol of receiving them by patients treated by different immunosuppressive agents. Here, we present different aspects of SARS-CoV-2 vaccination in such patients in the field of dermatology. In brief, SARS-CoV-2 vaccination is recommended in all dermatologic patients, regardless of their disorders and therapeutic regimens. Nevertheless, special considerations should be given to the immunosuppressive therapy and its association with vaccination timing due to the decreased immunogenicity of vaccines in this setting. Novel biologic immunotherapies are advantageous over conventional systemic therapies not only in their safety and selective functions but also in this aspect that many of them do not affect vaccines immunogenicity.

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

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.

Chilblain or perniosis-like skin lesions in children during the COVID-19 pandemic: A systematic review of articles.

COVID toes or chilblain-like skin lesions represent a widespread and specific skin presentation mostly in the feet that may be attributed to COVID-19 infection. They may last for several months. We conducted this study to investigate chilblain-like lesions in children during the COVID-19 pandemic, any predisposition, location, clinical course, and prognosis. We searched Google Scholar, Scopus, and Medline (PubMed) databases using the following keywords: "Coronavirus" OR "COVID-19" AND "Chilblains" OR "Pernio" OR "Perniosis" OR "Children" OR "Cutaneous" OR "skin." The inclusion criteria were: (a) Studies that described the specific vascular skin lesion. (b) Studies that included patients aged >1 month till 18 years. (c) Case reports, case series, retrospective or prospective cohort studies, case-control studies. A total of 28 articles were included. The total number of children with chiblain-like lesions (CLL) was 433. The mean age of children presenting CLL during the COVID-19 pandemic was estimated as 12.58 ± 2.15. Of note, 53.6% of them were male. The nasopharyngeal SARS-CoV-2 RT-PCR test and anti-SARS-CoV-2 antibodies were mostly negative for the virus. In conclusion, it is crucial to be familiar with various presentations of COVID-19 infection and their clinical significance to approach the earliest diagnosis, immediate treatment, estimate the prognosis, and finally isolate the patients to prevent spreading. Chilblain-like lesions as a possible cutaneous presentation of COVID-19 in children may last several months with the indolent course.

Impact of Coronavirus Disease 2019 Outbreak on Children and Adolescents with Type 1 Diabetes Mellitus.

BACKGROUND: This study aimed to investigate the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on daily routines and health of patients with type 1 diabetes mellitus (T1DM). STUDY DESIGN: A cross-sectional study. METHODS: This study included 98 children and adolescents with type 1 diabetes who were regularly followed up in the Endocrinology outpatient clinic of Besat Hospital, Hamadan, Iran, in 2020. The primary measurements included body mass index, glycemic control, number of hypoglycemic events, number of hospitalizations, as well as bedtime and availability of insulin six months pre and post COVID-19 outbreak. The obtained data were analyzed in SPSS software (version 16). A p-value less than 0.05 was considered statistically significant. RESULTS: Out of 98 participants (mean±SD age: 13.5±49), 51% of the cases were male, and %81.6 of the patients were urban residents. Furthermore, most participants (43.9%) were in the age group of 11-15 years, and the mean±SD duration of diabetes was 4.64±3.31 years. In addition, 2.04% of the participants developed COVID-19. There was a statistically significant difference among average duration of night sleep (P<0.001), bedtime (P<0.001), time of waking up (P<0.001), amount of insulin intake (P=0.003), daily exercise (P<0.001), and availability of the insulin (P<0.001) before and during COVID-19 crisis. The frequencies of hospitalizations and hypoglycemic events were lower after the COVID-19 outbreak (P=0.005 and P=0.034, respectively). Morning insulin dose was omitted in 22.2% of participants. No differences were found between hemoglobin A1c and daytime sleep pre and post COVID-19 outbreak. CONCLUSIONS: The key challenges due to COVID-19 pandemic restrictions for Iranian T1DM patients were the need to take more insulin, lower physical activity, non-availability of insulin, and missed morning insulin dose. However, it is worth mentioning that the patients' blood glucose control did not worsen in this period.

Cutaneous manifestations related to the COVID-19 pandemic: a review article.

BACKGROUND: Skin lesions are either caused by COVID-19 disease or they can be due to other driving forces related to the COVID-19 pandemic. AIM: Considering the fact that the reported data in different articles for the type and prevalence of skin manifestations related to the COVID-19 pandemic are inconsistent, we have described the mechanism and type of skin lesions related to the COVID-19 pandemic. METHODS: In this review article, we have searched the Medline database (PubMed) for the combination of the following key terms "Dermatological Manifestation", "cutaneous Manifestation", "Skin Manifestation", "COVID-19", "SARS-CoV-2". RESULTS: The prevalence of skin manifestations related to COVID-19 ranged from 0.2% to 20%. The majority of these skin lesions are maculopapular eruptions. The skin presentations related to the COVID-19 pandemic are described below. Traumatic skin conditions such as dermatitis in individuals, especially those with allergies, might initiate secondary to over-washing or rinsing with inappropriate detergents. Also, inappropriate use of personal protective equipment (mask-gloves-shield) can trigger skin lesions on the face and hands or aggravate the lesions of acne, seborrhoeic dermatitis, eczema, etc. Furthermore, cutaneous adverse drug reactions may occur during hospitalization or outpatient treatment of COVID-19 patients. Also, psychocutaneous disorders due to acute stress can trigger or deteriorate several skin manifestations. Moreover, COVID-19 prevalence and course may be changed in patients with autoimmune or chronic inflammatory underlying skin disorders such as psoriasis, lupus erythematosus, pemphigus, scleroderma who are on immunosuppressive or biological medications to control their disorders. CONCLUSION: Due to the various dimensions of skin organ involvement and the large population affected, long-term skin conditions following this pandemic can be a lot more problematic than it appears. Serious preventive measures and medical supports are necessary to avoid skin disorders from becoming permanent or even chronic.