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1.
Int J Dermatol ; 61(10): 1187-1204, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2019306

ABSTRACT

To date, over 250 million people have been reportedly infected by COVID-19 disease, which has spread across the globe and led to approximately 5.1 million fatalities. To prevent both COVID-19 and viral transmission, DNA-based/RNA-based vaccines, non-replicating viral vector vaccines, and inactivated vaccines have been recently developed. However, a precise clinical and histological characterization of SARS-CoV-2 vaccine-related dermatological manifestations is still lacking. A systematic review of 229 articles was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, in order to provide an extensive overview of SARS-CoV-2 vaccine-related skin manifestations. Data on demographics, number of reported cases with cutaneous involvement, vaccine, and rash type (morphology) were extracted from articles and summarized. A total of 5941 SARS-CoV-2 vaccine-related dermatological manifestations were gathered. Local injection-site reactions were the most frequently observed, followed by rash/unspecified cutaneous eruption, urticarial rashes, angioedema, herpes zoster, morbilliform/maculopapular/erythematous macular eruption, pityriasis rosea and pityriasis rosea-like eruptions, and other less common dermatological manifestations. Flares of pre-existing dermatological conditions were also reported. Cutaneous adverse reactions following SARS-CoV-2 vaccine administration seem to be heterogeneous, rather infrequent, and not life-threatening. Vaccinated patients should be monitored for skin manifestations, and dermatological evaluation should be offered, when needed.


Subject(s)
COVID-19 Vaccines , COVID-19 , Exanthema , Pityriasis Rosea , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Exanthema/etiology , Humans , SARS-CoV-2
3.
J Cosmet Dermatol ; 21(9): 3692-3703, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1916201

ABSTRACT

OBJECTIVES: In this study covering all of Turkey, we aimed to define cutaneous and systemic adverse reactions in our patient population after COVID-19 vaccination with the Sinovac/CoronaVac (inactivated SARS-CoV-2) and Pfizer/BioNTech (BNT162b2) vaccines. METHODS: This prospective, cross-sectional study included individuals presenting to the dermatology or emergency outpatient clinics of a total of 19 centers after having been vaccinated with the COVID-19 vaccines. Systemic, local injection site, and non-local cutaneous reactions after vaccination were identified, and their rates were determined. RESULTS: Of the 2290 individuals vaccinated between April 15 and July 15, 2021, 2097 (91.6%) received the CoronaVac vaccine and 183 (8%) BioNTech. Systemic reactions were observed at a rate of 31.0% after the first CoronaVac dose, 31.1% after the second CoronaVac dose, 46.4% after the first BioNTech dose, and 46.2% after the second BioNTech dose. Local injection site reactions were detected at a rate of 35.6% after the first CoronaVac dose, 35.7% after the second CoronaVac dose, 86.9% after the first BioNTech dose, and 94.1% after the second BioNTech dose. A total of 133 non-local cutaneous reactions were identified after the CoronaVac vaccine (2.9% after the first dose and 3.5% after the second dose), with the most common being urticaria/angioedema, pityriasis rosea, herpes zoster, and maculopapular rash. After BioNTech, 39 non-local cutaneous reactions were observed to have developed (24.8% after the first dose and 5% after the second dose), and the most common were herpes zoster, delayed large local reaction, pityriasis rosea, and urticaria/angioedema in order of frequency. Existing autoimmune diseases were triggered in 2.1% of the patients vaccinated with CoronaVac and 8.2% of those vaccinated with BioNTech. CONCLUSIONS: There are no comprehensive data on cutaneous adverse reactions specific to the CoronaVac vaccine. We determined the frequency of adverse reactions from the dermatologist's point of view after CoronaVac and BioNTech vaccination and identified a wide spectrum of non-local cutaneous reactions. Our data show that CoronaVac is associated with less harmful reactions while BioNTech may result in more serious reactions, such as herpes zoster, anaphylaxis, and triggering of autoimmunity. However, most of these reactions were self-limiting or required little therapeutic intervention.


Subject(s)
Angioedema , COVID-19 , Herpes Zoster , Pityriasis Rosea , Urticaria , Vaccines , Angioedema/chemically induced , BNT162 Vaccine , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Cross-Sectional Studies , Herpes Zoster/chemically induced , Herpes Zoster/prevention & control , Herpesvirus 3, Human , Humans , Pityriasis Rosea/chemically induced , Prospective Studies , SARS-CoV-2 , Turkey/epidemiology , Urticaria/chemically induced , Vaccination/adverse effects , Vaccines/adverse effects
4.
J Korean Med Sci ; 37(24): e190, 2022 Jun 20.
Article in English | MEDLINE | ID: covidwho-1902911

ABSTRACT

BACKGROUND: Pityriasis rosea (PR) is a papulosquamous eruption with generally unknown origin but suspected to be related to viral etiologies. The clinicopathological spectrum of several disorders with viral etiologies has been altered after the coronavirus disease 2019 (COVID-19) pandemic. The author group could experience coherent histological alterations in PR after the COVID-19 pandemic. This study aimed to investigate how the clinicopathological findings of PR were changed after the COVID-19 pandemic. METHODS: Patients (n = 11) diagnosed with PR based on the clinical manifestations and skin biopsies between February 2018 and October 2019 and 11 patients in February 2020 and October 2021 were retrospectively analyzed by investigating the medical records. RESULTS: The patients with PR during the COVID-19 pandemic demonstrated statistically significant histopathological alterations from classic brisk and dense infiltration pattern to dormant and sparse infiltration and psoriasiform-dominant patterns (P = 0.019). PR was associated with more frequent pruritus during the pandemic period (P = 0.027). CONCLUSION: In conclusion, PR demonstrated a significant histopathological alteration with more frequent pruritus during the COVID-19 pandemic. The comparative results about clinicopathological findings of PR will provide a useful reference for dermatologists in the diagnostic process of PR in the COVID-19 pandemic.


Subject(s)
COVID-19 , Pityriasis Rosea , Humans , Pandemics , Pityriasis Rosea/diagnosis , Pityriasis Rosea/epidemiology , Pityriasis Rosea/pathology , Pruritus/etiology , Retrospective Studies
6.
J Dermatol ; 49(10): 948-956, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1883156

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by the activation of a cytokine storm derived from an excess release of cytokine (interleukin [IL]-6, interferon [IFN] I, C-X-C motif chemokine ligand [CXCL]10, tumor necrosis factor [TNF]-α, macrophage inflammatory protein [MIP]1) due to an uncontrolled immune activation. There has been a fivefold increase in the number of cases of pityriasis rosea during the SARS-CoV-2 pandemic. Using the keywords "pityriasis" and "COVID-19", we carried out a PubMed search, including all articles in the English language published until November 2021. We aimed to investigate the possible connection between SARS-CoV-2 and pityriasis rosea (PR). Pityriasis could be considered an immunological disease due to the involvement of cytokines and chemokines. Our analysis yielded 65 articles of which 53 were not considered; the others (n = 12) concerning the association between PR and COVID-19 were included in our study. We suggest two mechanisms underlying the involvement of the skin in viral infections: (i) viruses directly affecting the skin and/or inducing host immune response thus causing cutaneous manifestations; and (ii) viruses as a possible inducer of the reactivation of another virus. The first mechanism is probably related to a release of pro-inflammatory cytokine and infection-related biomarkers; in the second, several pathways could be involved in the reactivation of other latent viruses (human herpesviruses 6 and 7), such as a cytokine-cytokine receptor interaction, the Janus kinase-signal transducer and activator of transcription signaling pathway, and the IL-17 signaling pathway. We thus believe that a cytokine storm could be directly or indirectly responsible for a cutaneous manifestation. More investigations are needed to find specific pathways involved and thus confirm our speculations.


Subject(s)
COVID-19 , Pityriasis Rosea , Chemokines , Cytokine Release Syndrome , Cytokines , Humans , Interferons , Interleukin-17 , Interleukin-6 , Janus Kinases , Ligands , Macrophage Inflammatory Proteins , Receptors, Cytokine , SARS-CoV-2 , Tumor Necrosis Factors
9.
J Popul Ther Clin Pharmacol ; 29(1): e109-e115, 2022.
Article in English | MEDLINE | ID: covidwho-1820554

ABSTRACT

BACKGROUND: A new type of coronavirus family severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that has been detected in individuals with several clinical symptoms named COVID-19, was recognized as a pandemic on March 11, 2020. Numerous researches have been conducted on the manifestations of a skin disease related to COVID-19, i.e., rashes or Pityriasis rosea (PR), vascular markings, and pimple-like lesions. AIM: This study aims to find out if the Coronavirus can affect the PR development, which also can be considered as a trigger and symptom for other types of infections. MATERIAL AND METHODS: This study is a case series describing the dermatological findings related to COVID-19 in the Thi-Qar Governorate. Samples were taken from inpatients, outpatients, and from the emergency unit of Al Hussein Teaching Hospital, and inwards of Al-Shefaa' Isolation Hospital. The study has been done over a 4 month period (June-September, 2020.). RESULTS: Around 19 patients, 10 females (52.6%) and 9 males (47.4%), who were infected with Coronavirus and were suffering from PR, are included in this study. The distribution of patients according to the incidence of PR in typical and anomalous manners were 77.9% and 21.1% respectively. The highest percentage of the incidence of PR was in moderate COVID-19 (84.2%), while it was around 15.8% in mild COVID-19. There was no significant statistical difference in the mean age distribution according to gender, while there was a significant statistical difference according to PR and COVID-19 class. More studies are needed to evaluate whether or not these lesions are associated with the virus. CONCLUSION: The PR was one of the dermatological finding of COVID-19 that did not have a clear role in the distribution of the disease according to the background of the patients, and also the severity of COVID-19. It can be triggered by COVID-19 and be completely cured with the clearance of the disease. RECOMMENDATION: An accurate robust cutaneous documentation related to COVID-19 is required to improve the knowledge of the disease as well as its epidemiology.


Subject(s)
COVID-19 , Pityriasis Rosea , Emergency Service, Hospital , Female , Humans , Male , Pandemics , Pityriasis Rosea/epidemiology , SARS-CoV-2
12.
Cutis ; 108(6): 317-318, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1687493

ABSTRACT

Pityriasis rosea is a common, self-limited, papulosquamous eruption, classically presenting along the Langer lines of the skin. We report a clinically typical case of pityriasis rosea that developed following COVID-19 vaccination. As the novel COVID-19 vaccine becomes more widely available during the ongoing COVID-19 pandemic, it is imperative for both patients and clinicians to be aware of its association with the onset of this benign cutaneous eruption.


Subject(s)
COVID-19 , Exanthema , Pityriasis Rosea , Vaccines , COVID-19 Vaccines , Exanthema/chemically induced , Humans , Pandemics , Pityriasis Rosea/chemically induced , SARS-CoV-2 , Vaccination/adverse effects
14.
J Formos Med Assoc ; 121(5): 1003-1007, 2022 May.
Article in English | MEDLINE | ID: covidwho-1599090

ABSTRACT

Pityriasis rosea (PR) is a self-limited disease with exanthematous papulosquamous rashes mostly associated with reactivation of human herpesvirus (HHV)-6 or HHV-7. PR-like eruptions, which occur along with peripheral eosinophilia, interface dermatitis, and eosinophils on histopathology, may result from medications or vaccinations. Previously, PR-like eruptions had been noted following vaccination for influenza or other vaccines. During this pandemic, acute COVID-19 infection has been related to PR or PR-like eruptions in several cases. Various COVID-19 vaccines associated with PR-like eruptions were rarely reported. Herein, we report a case of cutaneous PR-like eruptions following COVID-19 mRNA-1273 vaccination.


Subject(s)
COVID-19 , Exanthema , Herpesvirus 6, Human , Pityriasis Rosea , 2019-nCoV Vaccine mRNA-1273 , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , Pityriasis Rosea/etiology , Vaccination/adverse effects
20.
Dermatol Ther ; 34(6): e15129, 2021 11.
Article in English | MEDLINE | ID: covidwho-1416309

ABSTRACT

Pityriasis rosea (PR) has been manifested in patients suffering from COVID-19 as well as after vaccine protocols against SARS-CoV-2. It has a possible association with the HHV-6B virus (roseola infantum) and can be controlled by antivirals such as acyclovir as well as by the amino acid l-Lysine that showed a positive result in reducing the number of lesions and healing time. The aim of this study was to report a case of PR after a second dose of Oxford-AstraZeneca, the adopted therapy and a brief literature review. A 53-year-old woman, phototype II, presented an erythematous lesion in the posterior right thigh 15 days after the second dose of Oxford-AstraZeneca vaccine. Eight days after the initial injury, new injuries appeared in the calf, buttocks and thighs. The diagnosis was PR with a 5-week eruption cycle. The treatment consisted of the use of l-Lysine, 3 grams loading dose and 500 mg for 30 days and moisturizing/healing lotion, starting 14 days after the herald patch. After the 5th week of the disease cycle, there were no new eruptions and the repair cycle continued for up to 8 weeks leaving some residual skin spots. It is concluded that the patient may be a carrier a latent virus, HHV-6, and the vaccine administration with immune system stimulation, would have activated the possible virus causing PR. l-Lysine helped to control the manifestation by limiting the number of lesions and their location, which were restricted to the legs, thighs and buttocks.


Subject(s)
COVID-19 , Herpesvirus 7, Human , Pityriasis Rosea , Vaccines , Female , Humans , Middle Aged , Pityriasis Rosea/chemically induced , Pityriasis Rosea/diagnosis , SARS-CoV-2
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