Acute Generalized Exanthematous Pustulosis in Close Temporal Association with mRNA-1273 Vaccine

Mitri, Fouad; Toberer, Ferdinand; Enk, Alexander; Hartmann, Martin

doi:10.2340/actadv.v101.443

Cited by 7 publications

(6 citation statements)

References 9 publications

(9 reference statements)

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“…Four of the cases [ 15 , 16 , 17 , 18 ] were confirmed with histopathology examination revealing AGEP diagnosis with the presence of discrete and confluent pustules, contrary to the pustular psoriasis Kogoj’s spongiform pustules, which are the accumulations of neutrophils under the stratum corneum. AGEP was combined with DRESS in two of the reported cases.…”

Section: Resultsmentioning

confidence: 88%

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: Resultsmentioning

confidence: 88%

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

Karampinis,

Gravani,

Gidarokosta

et al. 2023

Vaccines

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“…En la revisión que hemos realizado solo se han descrito 6 pacientes con PEGA en relación con la vacunación frente al SARS-CoV-2, de los cuales ninguno recibió la vacuna de Pfizer-BioNTech. En cambio, sí se han descrito casos con las vacunas de Moderna, Astra Zeneca y Janssen [4][5][6][7] . Por otra parte, también se han descrito casos de PEGA en pacientes con LES, la mayoría asociados a tratamiento con hidroxicloroquina 8 .…”

Section: Discusión Y Conclusionesunclassified

“…Frecuentemente, la PEGA se ha relacionado con infecciones, antibióticos, antivirales (lopinavir/ritonavir) e hidroxicloroquina. En los casos previamente descritos de PEGA por vacuna contra el SARS-CoV-2, al igual que en el que presentamos, también se observaron leucocitosis y lesiones cutáneas con pequeñas pústulas diseminadas por todo el cuerpo, así como hallazgos histopatológicos de pústulas superficiales y espongiosis epidérmica, compatibles con PEGA [4][5][6][7] .…”

Section: Discusión Y Conclusionesunclassified

Pustulosis exantemática generalizada aguda desencadenada por la vacunación con Pfizer-BioNTech frente a la COVID-19

Arenas-Montes

Mora-Martín

Aguilar-Alba

et al. 2022

Rev Esp Casos Clin Med Intern

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La pustulosis exantemática generalizada aguda (PEGA) es un tipo de lesión cutánea poco común caracterizada por la aparición rápida e insidiosa de numerosas pústulas estériles sobre un fondo eritematoso. Esta reacción normalmente es desencadenada por fármacos, principalmente antibióticos y más raramente por otros tipos de desencadenantes como infecciones o vacunas. Se presenta el caso de una paciente que desarrolló PEGA tras la administración de la vacuna de Pfizer-BioNTech frente al SARS-CoV-2. Según nuestro conocimiento solo hay seis casos descritos por la vacuna frente al SARS-CoV-2 y ninguno de ellos por la vacuna de Pfizer-BioNTech.

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“…Various skin reactions, i.e., urticaria, morbilliform purpuric and/or edematous rash, erythromelalgia, pernio/chilblains, vasculitis, have been observed following vaccination with Pfizer-BioNTech or Moderna COVID-19 vaccines [6,7]. Only a few vaccine-related AGEP cases have been reported in the literature [8][9][10]. The observation of AGEP and similar pustular rashes in COVID-19 patients or following vaccination with an mRNA vaccine against COVID-19 suggests a similar immune activation leading to the development of AGEP/pustular psoriasis.…”

Section: Opis Przypadkumentioning

confidence: 99%

“…Różne zmiany skórne obserwowano także po szczepieniu szczepionką Pfizer-BioNtech lub Moderna przeciw COVID-19, takie jak pokrzywka, odropodobna osutka wybroczynowa lub obrzękowa, erytromelalgia, zmiany typu pernio oraz zapalenia naczyń [6,7]. W piśmiennictwie można znaleźć zaledwie kilka doniesień o wystąpieniu AGEP w związku ze stosowaniem szczepionek [8][9][10]. Obserwowane przypadki rozwoju AGEP i podobnych osutek krostkowych u pacjentów z COVID-19 lub po szczepieniu szczepionką mRNA przeciwko COVID-19 sugerują zbliżony mechanizm aktywacji immunologicznej prowadzący do rozwoju AGEP lub łuszczycy krostkowej.…”

Section: Conflict Of Interestunclassified

Acute generalized exanthematous pustulosis in temporal association with COVID-19 vaccine

Ozturk¹,

Ordu²

2022

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Introduction:Acute generalized exanthematous pustulosis is characterized by small, sterile, non-follicular, and sudden-onset pustular reactions on an erythematous surface. It typically involves intertriginous regions and the trunk and is usually accompanied by itching and a feeling of pain in the lesion areas. Often pharmacological treatments and frequent viral eruptions, including enterovirus, coxsackie, Epstein-Barr virus, and hepatitis B, play a role in the etiology of the disease. Case report: Here, we present the case of acute generalized exanthematous pustulosis in a 17-year-old young woman triggered by the 1 st dose of COVID19 mRNA BioNTech vaccine. Conclusions: We are reporting a rare case of vaccine-related acute generalized exanthematous pustulosis, associated with a COVID-19 vaccination.

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Acute Generalized Exanthematous Pustulosis in Close Temporal Association with mRNA-1273 Vaccine

Abstract: is missing (Short communication)

Cited by 7 publications

References 9 publications

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

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

Pustulosis exantemática generalizada aguda desencadenada por la vacunación con Pfizer-BioNTech frente a la COVID-19

Acute generalized exanthematous pustulosis in temporal association with COVID-19 vaccine

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