ABSTRACT
We report the case of a young female adult in her early 20s, who had COVID-19 infection for 8 weeks and COVID-19 vaccination 4 weeks prior to presentation with an extensive rash associated with erythema multiforme, resembling varicella zoster on initial presentation. After initial acyclovir therapy with no improvement, systemic corticosteroid treatment dramatically resolved the patient's skin rash.
Subject(s)
COVID-19 Vaccines , COVID-19 , Erythema Multiforme , COVID-19 Vaccines/adverse effects , Erythema Multiforme/chemically induced , Erythema Multiforme/drug therapy , Female , Humans , Tanzania , Vaccination/adverse effects , Young AdultABSTRACT
BACKGROUND: The 2019 Coronavirus disease (Covid-19) has affected thousands of people worldwide. To date, vaccines appear to be the only method to prevent and reduce mortality. Four vaccinations have been outwardly approved by European Medicine Agency (EMA) in Europe: BNT162b2 (Comirnaty-BioNTech/Pfizer), mRNA-1273 (Spikevax-Moderna), ChAdOx1 (VaxzevriaAstrazeneca), and Ad26.COV2-S (Janssen-Johnson&Johnson). After vaccination, local and systemic adverse effects can occur. Cutaneous reactions like urticaria, local injection site pain, morbilliform rash have been documented after vaccination. CASES PRESENTATION: We report four cases of oral erythema multiforme flare arising after BNT162b2 vaccination administration. All the patients denied previous erythema-like and herpetic manifestations history. Two of the reported cases (number 1 and 2) presented with both oral and cutaneous lesions, while cases 3 and 4 showed only oral manifestations. Three of the cases presented the erythema after the first vaccination dosage administration, only one case reported lesions after the second vaccination dosage administration. All the cases were treated with prednisone via oral administration and topical 0.05% clobetasol ointment. CONCLUSIONS: The present reports represent some of the few cases of erythema multiforme occurring as a side effect of the BNT162b2 COVID-19 vaccination. The causal role of the vaccine for the erythema multiforme has not been proven yet; nevertheless, it is not uncommon for medications to trigger this disease. The vaccine could surface a silent herpes virus infection, which would induce the erythema multiforme instead.
Subject(s)
COVID-19 , Erythema Multiforme , BNT162 Vaccine/adverse effects , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Erythema Multiforme/chemically induced , Erythema Multiforme/drug therapy , Humans , Vaccination/adverse effectsSubject(s)
COVID-19 , Eosinophilia , Erythema Multiforme , BNT162 Vaccine , COVID-19 Vaccines , Erythema Multiforme/chemically induced , Humans , RNA, Messenger , SARS-CoV-2Subject(s)
2019-nCoV Vaccine mRNA-1273/adverse effects , BNT162 Vaccine/adverse effects , COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Erythema Multiforme/chemically induced , Pityriasis Lichenoides/chemically induced , Pityriasis Rubra Pilaris/chemically induced , Sweet Syndrome/chemically induced , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , SARS-CoV-2ABSTRACT
We report a case of a patient with erythema multiforme major following COVID-19 (coronavirus disease 2019) vaccination. Lesions on skin and mucous membranes developed 48â¯h after the second dose of the mRNA-vaccine BNT162b2 (Tozinameran, Comirnaty®). Under the application of external glucocorticoids complete resolution was achieved within 3 weeks.
Subject(s)
COVID-19 , Erythema Multiforme , BNT162 Vaccine , COVID-19 Vaccines , Erythema Multiforme/chemically induced , Erythema Multiforme/diagnosis , Humans , SARS-CoV-2 , Vaccination/adverse effectsSubject(s)
COVID-19 , Erythema Multiforme , COVID-19 Vaccines , Erythema Multiforme/chemically induced , Humans , SARS-CoV-2Subject(s)
COVID-19 , Erythema Multiforme , BNT162 Vaccine , COVID-19 Vaccines , Erythema Multiforme/chemically induced , Humans , SARS-CoV-2ABSTRACT
Background: Erythema multiforme (EM) is an acute cutaneous eruption often associated with infections and more rarely with drugs. This review aimed to evaluate the association between erythema multiforme and coronavirus disease 2019 (COVID-19). Methods: A systematic search of PubMed/MEDLINE, Scimago Scopus, and ISI/Web of Science was performed. Original articles, case series, or case reports were evaluated and selected. Results: Fourteen articles were selected, describing a total of 70 patients. EM is a cutaneous eruption rarely occurring in COVID-19 and is, in most cases, associated with a hypersensitivity reaction to the virus. In these cases, EM seems to affect patients younger than 30 years or older than 55 years. Infrequently, some drugs used in the management of COVID-19 may induce EM, especially hydroxychloroquine. The three groups of patients seem to have different clinical characteristics and courses. Conclusions: From these data, it is possible to preliminarily propose that EM or EM-like eruptions linked to COVID-19 might be divided into three types: the virus-related juvenile type (affecting patients <30-year-old), the virus-related older type (affecting patients >55 years), and the drug-induced type. The occurrence of a skin rash does not seem to be related to the severity and clinical course of COVID-19.