Acute generalized exanthematous pustulosis and epidermal necrolysis differ in innate cytokine patterns

Lalevée, Sébastien; Audureau, Étienne; Riou, Audrey; Colin, A.; Anquetin, Maxime; Barau, Caroline; Valeyrie‐Allanore, Laurence; Delfau‐Larue, Marie‐Hélène; Chosidow, Olivier; Wolkenstein, Pierre; Ingen‐Housz‐Oro, Saskia; Hüe, Sophie

doi:10.1111/cea.13449

Cited by 4 publications

(2 citation statements)

References 10 publications

(12 reference statements)

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“…Additionally, IL-6, compared with the other cytokines that are raised in pustular psoriasis, showed the strongest correlation with disease severity and systemic inflammation [45]. IL1 and IL6 are also noted to be high in the blood of patients with AGEP [46,47]. The dysregulated cytokine network triggered by the vaccine can lead to the imbalance of pro-inflammatory cytokines in neutrophilic dermatosis, leading to an overactive neutrophil response and persistent inflammation [48].…”

Section: Discussionmentioning

confidence: 99%

Pustular Eruption following COVID-19 Vaccination: A Narrative Case-Based Review

Karampinis,

Gravani,

Gidarokosta

et al. 2023

Vaccines

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From the beginning of public vaccinations until the relaxation of COVID-19 measures, many case reports, case series and case–control studies have been published indicating cutaneous side effects of COVID-19 vaccination. Post-vaccination pustular eruption was reported as well, with a challenging differential diagnosis between pustular psoriasis, AGEP (acute generalized exanthematous pustulosis) and neutrophil pustular eruptions. We report a case of 56-year-old woman presented with acute generalized pustular flare up culminated 5 days after the second dose of BNT162b2(Pfizer) vaccination. She was diagnosed with pustular psoriasis flare and due to the regulating role of IL-1 in pustular psoriasis and in the cytokine storm observed in cases of COVID-19 postvaccination inflammation; we decided to treat the patient with an IL-1 antagonist, subcutaneous anakinra (100 mg daily) along with acitretin. One week later, after anakinra withdrawal, she presented a pustular psoriasis flare and a 7-day anakinra re-administration led to a satisfactory improvement in the skin lesions. We also reviewed the medical literature and found 28 case reports with pustular eruption after the COVID-19 vaccination. We compared the patients reported, regarding sex, age, number of doses, post-vaccination period and vaccine brand, and compared those results with our patient. Finally, as indicated by our case and other cases with similarly treated pustular eruptions. targeted therapy to this cytokine imbalance such as anakinra (IL-1) antagonist can improve the clinical course of the patient.

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Section: Discussionmentioning

confidence: 99%

Pustular Eruption following COVID-19 Vaccination: A Narrative Case-Based Review

Karampinis,

Gravani,

Gidarokosta

et al. 2023

Vaccines

View full text Add to dashboard Cite

show abstract

“…HMGB1 (high-mobility group box 1) et IL-33 sont des alarmines dont les taux sont augmentés dans les lésions de NE [60,61]. Elles pourraient entretenir la réaction immunitaire dans la peau, d'autant plus que la régulation de la voie de l'IL-33 semble défectueuse dans les NE avec des taux moins élevés du récepteur soluble antagoniste de l'IL-33, sST2, dans le sérum de ces patients par rapport aux autres toxidermies comme la PEAG notamment [62].…”

Section: Mécanismes De Mort Des Kératinocytesunclassified