RESUMO
Viral vector vaccines (Covishield) and inactivated vaccines (Covaxin) are now being administered worldwide to reduce the impact of life-threatening corona virus disease 19 (COVID-19). Various cutaneous adverse drug reactions (CADRs) have been reported following COVID-19 vaccination. Here, we are reporting series of CADRs following COVID-19 vaccination. Among 18 CADRs, 4 each were of acute urticaria and pityriasis rosea, 2 each of leukocytoclastic vasculitis and herpes zoster, 3 exacerbation of psoriasis, and 1 each of exacerbation of eczema, reactivation of herpes simplex virus 1 infection, and COVID arm. However, in 1 case there was remission of psoriasis. These CADRs occurred between 6 hours and 20 days after vaccination and were mild to moderate in severity. Only 1 needed hospitalization. Of the 18 CADRs, 10 developed after first dose and 8 after second dose. Causality assessment was done using World Health Organization causality assessment classification. Mass COVID-19 vaccination program is in progress worldwide. Many CADRs like COVID arm, urticaria, pityriasis rosea, leukocytoclastic vasculitis, herpes zoster etc., have been reported following vaccination. In our series only 1 developed cutaneous adverse drug reaction (CADR) to Covaxin. It was Covishield that was administered during the vaccination drive; hence, more cases were seen to that vaccine. Most of the CADRs were mild to moderate in intensity. Awareness of these adverse effects enables the healthcare professionals to be better equipped to recognize and manage them correctly.
RESUMO
Vorderman (1901) was the first to record blisters caused by beetles in medical literature. Blister beetle dermatitis is a cutaneous condition caused by the toxins released by blister beetles. The vesicant chemical in the body fluids of these insects causes an acute irritant contact dermatitis characterized by erythematovesicular lesions associated with burning sensation on exposed parts of the body. The aim of this study was to investigate the morphological patterns of blister beetle dermatitis. We conducted a 1-year (January-December 2014) prospective study of the clinical presentation of Paederus dermatitis noticed in urban and semiurban areas close to paddy fields in the Cauvery Basin, Mysuru, Karnataka. All patients with Paederus dermatitis attending the outpatient department of Department of Dermatology were recruited in the study with a total of 37 patients. Diagnosis was made on detailed history regarding onset of lesions, symptoms, as well as thorough clinical examination of the lesions. The peak time of presentation was June-September, the monsoon season in this part of India. The average duration of lesions at the time of presentation was 2-5 days. All patients had a history of burning and itchy sensation at night followed by full blown lesions the next morning, with the face, neck, and arms being the most common sites. Patients were predominantly males with the age range of 13-55 years. The most common presentations were linear erythematous plaques and erythematovesicles with a "burnt" appearance and a gray necrotic centre. "Kissing" lesions and periorbital involvement were seen in 5 and 6 patients, respectively. Species identification of the Paederus beetles was not done. Paederus dermatitis occurs in tropical regions. Awareness about the morphological patterns of the condition will prevent misdiagnosis. Simple preventive measures can be undertaken based on the behavioral pattern of this nocturnal beetle.
