Successful Management of Erythema Dyschromicum Perstans Following Topical Ruxolitinib Therapy.

Erythema dyschromicum perstans (EDP) is a rare cutaneous disorder in which patients develop gray or blue-brown macules or patches on their bodies.1 This condition does not appear to have a gender or age predilection. The diagnosis of EDP is essentially clinical, with histopathology findings being nonspecific. To date, treatment for EDP varies. The use of several therapies, including dapsone, clofazimine, retinoid A, tacrolimus, and ultraviolet light have been reported but with minimal effectiveness.5 We report a case of EDP occurring in a patient following the COVID-19 vaccine that was given topical ruxolitinib with success in treatment. To our knowledge, this is the first report of the use of topical ruxolitinib in treatment of EDP with successful management. J Drugs Dermatol. 2022;22(3): doi:10.36849/JDD.7156.

Histopathological analysis of skin reactions after coronavirus disease 2019 vaccination: Increment in number of infiltrated plasmacytoid dendritic cell.

Skin disorders are frequent adverse events after coronavirus disease 2019 (COVID-19) vaccination. However, the pathogenesis of these disorders is not fully understood. Here, we report a case series of cutaneous adverse events following COVID-19 vaccination, and the results of our investigation reveal the underlying mechanism. Case 1: a 47-year-old female developed a wheal, confined to the COVID-19 vaccination site, 2 days after her first injection. She was treated with topical steroids and oral antihistamines. Case 2: a 51-year-old female showed generalized petechial erythema accompanied by fever, genital bleeding, thrombocytopenia, liver dysfunction, and disseminated intravascular coagulation, 2 days after her second injection. She was diagnosed with vaccine-induced macrophage activation syndrome and treated with anti-inflammatory therapy. Immunohistological analysis of the skin eruption, in both these cases, showed infiltration of CD123+ BDCA2+ plasmacytoid dendritic cells (p-DC). Despite the distinctive clinical features in these two cases, this finding suggests that p-DC might be involved in different cutaneous adverse events after COVID-19 vaccination.

Erythema annulare centrifugum induced by COVID-19 vaccination.

With the expansion of the COVID-19 vaccination drive, an increasing number of adverse effects are surfacing. A 74-year-old woman presented with multiple erythematous and itchy patches on several sites. She had no relevant medical history, apart from the first AZD1222 vaccination 1 month previously. Microscopically, epidermal changes, including mild spongiosis and parakeratosis, were observed. Tight perivascular lymphocytic infiltration (coat-sleeve pattern) was also observed in the dermis. The final diagnosis was erythema annulare centrifugum (EAC) induced by SARS-CoV-2 vaccination. Based on this report, dermatologists should be aware of the possibility of EAC from the AZD1222 vaccination.