Clinical and pathologic correlation of cutaneous COVID-19 vaccine reactions including V-REPP: A registry-based study.
J Am Acad Dermatol
; 86(1): 113-121, 2022 01.
Article
in English
| MEDLINE | ID: covidwho-1401554
ABSTRACT
BACKGROUND:
Cutaneous reactions after COVID-19 vaccination have been commonly reported; however, histopathologic features and clinical correlations have not been well characterized.METHODS:
We evaluated for a history of skin biopsy all reports of reactions associated with COVID-19 vaccination identified in an international registry. When histopathology reports were available, we categorized them by reaction patterns.RESULTS:
Of 803 vaccine reactions reported, 58 (7%) cases had biopsy reports available for review. The most common histopathologic reaction pattern was spongiotic dermatitis, which clinically ranged from robust papules with overlying crust, to pityriasis rosea-like eruptions, to pink papules with fine scale. We propose the acronym "V-REPP" (vaccine-related eruption of papules and plaques) for this spectrum. Other clinical patterns included bullous pemphigoid-like (n = 12), dermal hypersensitivity (n = 4), herpes zoster (n = 4), lichen planus-like (n = 4), pernio (n = 3), urticarial (n = 2), neutrophilic dermatosis (n = 2), leukocytoclastic vasculitis (n = 2), morbilliform (n = 2), delayed large local reactions (n = 2), erythromelalgia (n = 1), and other (n = 5).LIMITATIONS:
Cases in which histopathology was available represented a minority of registry entries. Analysis of registry data cannot measure incidence.CONCLUSION:
Clinical and histopathologic correlation allowed for categorization of cutaneous reactions to the COVID-19 vaccine. We propose defining a subset of vaccine-related eruption of papules and plaques, as well as 12 other patterns, following COVID-19 vaccination.Keywords
AZD1222; Ad26.COV2.S; BNT162b2; COVID-19; Johnson & Johnson Janssen; Moderna; Oxford-AstraZeneca; Pfizer-BioNTech; SARS-CoV-2; Stevens-Johnson syndrome; bullous pemphigoid; chilblains; delayed large local; dermal hypersensitivity reaction; dermatology; dermatopathology; erythema multiforme; erythromelalgia; lichen planus; mRNA-1273; morbilliform; papular; papulosquamous; pathology; pernio; pityriasis rosea; psoriasis; registry; urticaria; vaccine; zoster
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Skin Diseases
/
Exanthema
/
COVID-19 Vaccines
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Vaccines
Limits:
Humans
Language:
English
Journal:
J Am Acad Dermatol
Year:
2022
Document Type:
Article
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