Autoimmune mucocutaneous blistering diseases after SARS-Cov-2 vaccination: A Case report of Pemphigus Vulgaris and a literature review

Calabria, Elena; Canfora, Federica; Mascolo, Massimo; Varricchio, Silvia; Mignogna, Michele Davide; Adamo, Daniela

doi:10.1016/j.prp.2022.153834

Cited by 44 publications

(45 citation statements)

References 37 publications

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“…Five additional records [ 18 , 19 , 20 , 21 , 22 ], manually retrieved through the reference lists of the eight articles already included in the present systematic review [ 9 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ] and compliant with currently applied eligibility criteria were considered for the current systematic review.…”

Section: Resultsmentioning

confidence: 99%

“…Comorbidities and related treatments, reported in 5 cases, were: Leiden factor V mutation in a 31 year old female taking oral contraceptives [ 18 ]; diabetes mellitus and hypertension, treated with amlodipine, teneligliptin, and metformin in a 60-year-old male [ 20 ]; benign pemphigoid of mucous membranes [ 29 ] and celiac disease [ 29 ] in a 55- and a 20-year-old female, respectively; and a 58-year-old female, under sertraline, lorazepam, atorvastatin, metamizole, and penicillin [ 9 ]. Eight participants had a negative history of COVID-19 [ 9 , 18 , 21 , 25 , 29 ], while in one case, the subject became positive for SARS-CoV-2 in the time between the first and second vaccine dose [ 23 ]; in the remaining 7 cases, the previous history of COVID-19 was not specified [ 19 , 20 , 21 , 22 , 24 , 26 , 27 , 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…Out of the 16 cases diagnosed with oral lesions following anti-SARS-CoV-2 vaccination, 9 cases were diagnosed with oral lesions following the administration of the Pfizer-BioNTech vaccine [ 19 , 24 , 25 , 26 , 28 , 29 ], 2 cases after vaccination with the Moderna vaccine [ 9 , 27 ], and 1 case was described after AstraZeneca [ 18 ], Serum Institute of India [ 20 ], Sinopharm Beijing [ 23 ], and Johnson & Johnson [ 22 ] vaccines, respectively. Oral lesions occurred consequent to the single dose of the Johnson & Johnson vaccine in one case [ 22 ], after the administration of the first dose in a total of 8 cases (5 after the Pfizer-BioNTech [ 19 , 26 , 28 , 29 ], and 1 after the AstraZeneca [ 18 ], Serum Institute of India [ 20 ], and Sinopharm Beijing [ 23 ] vaccines, respectively) and in 7 cases after the administration of thesecond dose (4 after the Pfizer-BioNTech, 2 after Moderna, and 1 after Sinopharm Beijing vaccines, respectively) [ 9 , 24 , 25 , 26 , 27 , 29 ]. In one case [ 21 ], data concerning vaccine type and dose were missing.…”

Section: Resultsmentioning

confidence: 99%

“…Diagnostic procedures performed were reported in 12 studies [ 9 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ] and comprised: ( n = 8) serological tests, altogether for herpes simplex type 1 and 2, Epstein Barr, human immunodeficiency, hepatitis B and C viruses, cytomegalovirus, mycoplasma pneumoniae, chlamydia pneumoniae, and treponema pallidum; ( n = 1) Nucleic Acid Amplification Test (NAAT); ( n = 2) real-time reverse transcription-polymerase chain reaction (RT-PCR); ( n = 1) nasopharyngeal swab; 8 biopsies; 1 case of removal of amalgam restorations; ( n = 1) direct immunofluorescence test; ( n = 1) skin allergy test; and ( n = 2) maneuvers for evaluation of Nikolsky’s sign. Histological examination was performed in only fourstudies [ 21 , 22 , 25 , 27 ].…”

Section: Resultsmentioning

confidence: 99%

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

Spirito

Amato

Palo

et al. 2022

IJERPH

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Increasing evidence relate anti-SARS-CoV-2 vaccinations to orofacial adverse reactions, therefore, the present systematic review aimed to evaluate primary oral lesions diagnosed in adult subjects, following the WHO Emergency Use Listing approved and EMA authorized vaccines, also in relation to cases’ age, gender, comorbidities, and history of COVID-19, and in relation to vaccine type and doses. The study protocol, registered on PROSPERO (CRD42022339032) and compliant with the PRISMA statement, included an electronic search across Scopus, MEDLINE/PubMed, BioMed Central databases, and PROSPERO, ended on 18 June 2022 and succeeded by a manual search, an independent data extraction, and arisk of bias evaluation through ROBINS-I tool. Qualitatively synthesized data from the 13studies included showed an overall low prevalence (16 cases), though higher in females (68.8%), of oral lesions, mainly erosions and ulcers (34.5%). Nine cases were diagnosed following Pfizer-BioNTech, two Moderna, and one AstraZeneca, Serum Institute of India, Sinopharm, and Johnson&Johnson vaccines, respectively; specifically, eight after the first dose and seven after the second. In one case, vaccine type and dose were not specified. Considering newly developing vaccines, presented findings may be updated and further studies needed to highlight factors affecting oral lesion occurrence and specific macro-microscopic phenotypes in relation to cases’ and vaccines’ characteristics.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

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

Spirito

Amato

Palo

et al. 2022

IJERPH

View full text Add to dashboard Cite

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“…Contrary to the common epidemiology of AIBDs, they reported a female to male ratio of 1:1.7. The bullous lesions were presented after a median of 7 days (IQR: 3–14) following vaccine shots ( 21 ). In the largest case series of patients with SARS-CoV-2 vaccine-associated bullous pemphigoid, characteristics of 21 patients were compared to idiopathic disease.…”

Section: Discussionmentioning

confidence: 99%

Exacerbation of Autoimmune Bullous Diseases After Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination: Is There Any Association?

et al. 2022

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Background and AimThere have been concerns regarding the potential exacerbation of autoimmune bullous diseases (AIBDs) following vaccination against COVID-19 during the pandemic. In the current study, vaccine safety was evaluated in patients with AIBDs.MethodsIn this study, patients with AIBDs were contacted via face-to-face visits or phone calls. Patient demographics, vaccine-related information, pre- and post-vaccine disease status, and complications were recorded. The exacerbation was considered either relapse in the remission/controlled phase of the disease or disease worsening in the active phase. The univariate and multivariate logistic regression tests were employed to determine the potential risk factors of disease exacerbation.ResultsOf the patients contacted, 446 (74.3%) reported receiving at least one dose of vaccine injection (54.7% female). Post-vaccine exacerbation occurred in 66 (14.8%) patients. Besides, there were 5 (1.1%) patients with AIBD diagnosis after vaccination. According to the analysis, for every three patients who received vaccines during the active phase of the disease one experienced disease exacerbation. The rate of disease exacerbation increased by three percent with every passing month from the last rituximab infusion. Active disease in the past year was another risk factor with a number needed to harm of 10.ConclusionRisk of AIBD exacerbation after the COVID-19 vaccine is not high enough to prevent vaccination. This unwanted side effect, can be reduced if the disease is controlled at the time of vaccination.

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