Cutaneous hypersensitivity reaction with acute hepatitis following COVID-19 vaccine

Wong, Christine Y.; Rios, Eon J.

doi:10.1016/j.jdcr.2021.08.008

Cited by 8 publications

(4 citation statements)

References 3 publications

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“…A total of 41 of 287 patients were managed in the inpatient setting and received some courses of intravenous therapy, 18 of which had a history of immune system dysregulations, such as different types of cancers, diabetes mellitus, chronic kidney disease, Grave thyroiditis, systematic lupus erythematosus, pemphigus vulgaris, psoriasis, and the like. 11,12,32,41,54,66,80,91,97,113,116,118,125 However, there were no significant risk factors for relapse of such lesions after further doses of vaccination.…”

Section: Discussionmentioning

confidence: 93%

“…[35][36][37]39,40 There was also a unique case with evidence of extremely dilated dermal vessel, RBC extravasate, and nuclear dust in pathology. 39 Erythematous/Maculopapular/Morbilliform Rash Histopathologic studies on post-COVID vaccination revealed erythematous, maculopapular, and morbilliform rashes with perivascular and perifollicular lymphohistiocytic infiltrates, 35,[41][42][43][44][45][46][47] neutrophils, and abundant eosinophils in the epidermis, 35,43 spongiosis, basal cell vacuolization, 42,43,46 and apoptotic cells, 43,47 with morbilliform erythema. Histopathology of erythematous maculopapular plaques or patches were reported as follows: inflammatory infiltrates within dermis primarily including lymphocytes, eosinophils, and occasional histiocytes, 38,42,43,[48][49][50][51][52][53] spongiosis, RBCs extravasation, 38,42,44,48,52,53 widened rete ridges, 54 orthokeratosis, parakeratosis, 38,45,54 and vacuolization of basal layer cells.…”

Section: Urticaria and Angioedemamentioning

confidence: 99%

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A Systematic Review of Histopathologic Surveys on Mucocutaneous Biopsies in Patients Developed COVID-19 Vaccine-Related Dermatologic Manifestations

Salehi

Sadeghi

Kalantari

et al. 2022

The American Journal of Dermatopathology

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Section: Discussionmentioning

confidence: 93%

Section: Urticaria and Angioedemamentioning

confidence: 99%

A Systematic Review of Histopathologic Surveys on Mucocutaneous Biopsies in Patients Developed COVID-19 Vaccine-Related Dermatologic Manifestations

Salehi

Sadeghi

Kalantari

et al. 2022

The American Journal of Dermatopathology

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“…In cases where the same sample was used for more than one study, all studies were reviewed to determine the extent to which there may be duplication in the reported outcomes between studies. The full text of selected studies was reviewed, and data on demographics, article type, number of reported cases with cutaneous involvement, vaccine, and rash type (morphology) were extracted from articles texts, tables, figures, and summarized through a descriptive table (Table 1)…”

Section: Methodsmentioning

confidence: 99%

SARS‐CoV‐2 vaccine‐related cutaneous manifestations: a systematic review

et al. 2022

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To date, over 250 million people have been reportedly infected by COVID‐19 disease, which has spread across the globe and led to approximately 5.1 million fatalities. To prevent both COVID‐19 and viral transmission, DNA‐based/RNA‐based vaccines, non‐replicating viral vector vaccines, and inactivated vaccines have been recently developed. However, a precise clinical and histological characterization of SARS‐CoV‐2 vaccine‐related dermatological manifestations is still lacking. A systematic review of 229 articles was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, in order to provide an extensive overview of SARS‐CoV‐2 vaccine‐related skin manifestations. Data on demographics, number of reported cases with cutaneous involvement, vaccine, and rash type (morphology) were extracted from articles and summarized. A total of 5941 SARS‐CoV‐2 vaccine‐related dermatological manifestations were gathered. Local injection‐site reactions were the most frequently observed, followed by rash/unspecified cutaneous eruption, urticarial rashes, angioedema, herpes zoster, morbilliform/maculopapular/erythematous macular eruption, pityriasis rosea and pityriasis rosea‐like eruptions, and other less common dermatological manifestations. Flares of pre‐existing dermatological conditions were also reported. Cutaneous adverse reactions following SARS‐CoV‐2 vaccine administration seem to be heterogeneous, rather infrequent, and not life‐threatening. Vaccinated patients should be monitored for skin manifestations, and dermatological evaluation should be offered, when needed.

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“…While isolated cutaneous reactions are not uncommon, 1 coronavirus (COVID-19) vaccine-associated cutaneous hypersensitivity reaction with acute hepatitis has been described. 2 Delayed-reading intradermal tests (IDT) to the COVID-19 vaccines can be performed, but a positive reading may represent evidence of cell-mediated immunity rather than a vaccine allergy. 3 In vitro diagnostic testing remains limited in the assessment of suspected delayed hypersensitivity reactions (DHRs) to COVID-19 vaccines and/or their components.…”

Section: Introductionmentioning

confidence: 99%

The role of lymphocyte transformation tests (LTT) in suspected severe delayed hypersensitivity reactions following COVID-19 vaccination

Weir

Jang

Fernando

2023

Human Vaccines & Immunotherapeutics

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Coronavirus (COVID-19) vaccines have proved to be effective in the pandemic response but can cause adverse events such as delayed hypersensitivity reactions (DHRs). Delayed-reading intradermal tests (IDT) to vaccines are limited by false-positive results and may reflect a cell-mediated rather than IgE-mediated immune response. Lymphocyte transformation test (LTT), which has been utilized in the diagnosis of drug allergy, may be helpful in suspected COVID-19 vaccine and/or its excipient-related DHRs. To investigate the use of LTT in two suspected cases of COVID-19 vaccine-induced DHRs, two patients with suspected DHRs to COVID-19 vaccination were tested by delayed-reading IDT and LTT against vaccines and their excipients. A 47-year-old man developed acute mixed-pattern hepatitis after the second dose of ChAdOx1 vaccine. LTT performed at 2 months post-vaccination revealed reactivity to the ChAdOx1 vaccine, polysorbate 80 and mildly to PEG 2050 but not BNT162b2 vaccine. Delayed-reading IDT returned negative to both vaccines and excipients. He tolerated BNT162b2 vaccination with no adverse events. A 36-year-old woman presented with subacute morbilliform eruption and hepatitis after the first dose of BNT162b2 vaccine. LTT performed 3 months later revealed reactivity to the BNT162b2 but not PEG 2050. Repeat LTT following subsequent natural Severe Acute Respiratory Coronavirus-2 (SARS-CoV-2) infection revealed reactivity to ChAdOx1 and NVX-CoV2373 vaccines but not polysorbate 80. Delayed-reading IDT remained negative. She proceeded with NVX-CoV2373 vaccination with no symptom recurrence. LTT may be a useful tool in suspected COVID-19 vaccine-related DHRs. Further evaluation with a larger patient cohort is required.

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Cutaneous hypersensitivity reaction with acute hepatitis following COVID-19 vaccine

Cited by 8 publications

References 3 publications

A Systematic Review of Histopathologic Surveys on Mucocutaneous Biopsies in Patients Developed COVID-19 Vaccine-Related Dermatologic Manifestations

A Systematic Review of Histopathologic Surveys on Mucocutaneous Biopsies in Patients Developed COVID-19 Vaccine-Related Dermatologic Manifestations

SARS‐CoV‐2 vaccine‐related cutaneous manifestations: a systematic review

The role of lymphocyte transformation tests (LTT) in suspected severe delayed hypersensitivity reactions following COVID-19 vaccination

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