A systematic review on mucocutaneous presentations after COVID‐19 vaccination and expert recommendations about vaccination of important immune‐mediated dermatologic disorders

Abstract

With dermatologic side effects being fairly prevalent following vaccination against COVID‐19, and the multitude of studies aiming to report and analyze these adverse events, the need for an extensive investigation on previous studies seemed urgent, in order to provide a thorough body of information about these post‐COVID‐19 immunization mucocutaneous reactions. To achieve this goal, a comprehensive electronic search was performed through the international databases including Medline (PubMed), Scopus, Cochrane, Web of science, and Google scholar on July 12, 2021, and all articles regarding mucocutaneous manifestations and considerations after COVID‐19 vaccine administration were retrieved using the following keywords: COVID‐19 vaccine, dermatology considerations and mucocutaneous manifestations. A total of 917 records were retrieved and a final number of 180 articles were included in data extraction. Mild, moderate, severe and potentially life‐threatening adverse events have been reported following immunization with COVID vaccines, through case reports, case series, observational studies, randomized clinical trials, and further recommendations and consensus position papers regarding vaccination. In this systematic review, we categorized these results in detail into five elaborate tables, making what we believe to be an extensively informative, unprecedented set of data on this topic. Based on our findings, in the viewpoint of the pros and cons of vaccination, mucocutaneous adverse events were mostly non‐significant, self‐limiting reactions, and for the more uncommon moderate to severe reactions, guidelines and consensus position papers could be of great importance to provide those at higher risks and those with specific worries of flare‐ups or inefficient immunization, with sufficient recommendations to safely schedule their vaccine doses, or avoid vaccination if they have the discussed contra‐indications.

Pemphigus during the COVID-19 Epidemic: Infection Risk, Vaccine Responses and Management Strategies

“…Overall, basic infection-prevention principles should be strictly adhered and drug-induced immunosuppression should be minimized as possible in treating pemphigus patients [ 82 ]. As the COVID-19 vaccine has become widely distributed, surveillance of safety issues related to these vaccines is progressing, vaccination should not be hindered through false beliefs about the extension or flare-ups, the prevalence of adverse events, as well as inefficient immunization, so that critical or potentially fatal adverse reactions could be safely avoided [ 83 ]. Due to the limited data about the diagnosed pemphigus following the COVID-19 vaccine in clinic, it is incapable to draw a definite conclusion that the COVID-19 vaccine may trigger the onset, exacerbation, or relapse of pemphigus thus far.…”

Oral Lesions Following Anti-SARS-CoV-2 Vaccination: A Systematic Review

“…Adverse drug reactions (ADRs) are potentially dangerous sequelae related to the use of medicinal products [ 1 , 2 ], including vaccines [ 3 ]. Mucocutaneous ADRs, potentially involving the oral cavity, have been previously reported following vaccines against several viruses (hepatitisB, influenza, measles, mumps, and rubella) and bacteria (Clostridium tetani, Corynebacterium diphtheria, and Bordetella pertussis) [ 3 , 4 , 5 ]. Moreover, orofacial ADRs, such as temporary one-sided facial drooping and tongue, face, or throat swelling, have also been described following anti-SARS-CoV-2 vaccines, along with skin and oral lesions [ 3 , 4 , 5 ].…”

More data on erythema annulare centrifugum induced by COVID ‐19 vaccination

“… 1 So far, more than 11 billion vaccine doses against SARS‐CoV‐2 have been administered worldwide. The number of vaccine‐induced cutaneous side‐effects reported in the literature is continuously increasing, and most SARS‐CoV‐2‐associated comprise local side reactions, delayed large local side reactions, urticaria, morbilliform exanthema, erythromelalgia, and reactivation of viral infections 2 , 3 We would like to add a second patient with recurring episodes of EAC following mRNA‐based vaccination with BNT162b2 as well as administration of the first and second booster dose. Experimental subcutaneous injection of BNT162b2 in this patient resulted in a sudden deterioration of EAC.…”