Haemorrhagic bullous pyoderma gangrenosum following <scp>COVID</scp>‐19 vaccination

Hung, Yi‐Teng; Chung, Wen Hung; Tsai, Tsung-Fu; Chen, Chun‐Bing

doi:10.1111/jdv.18132

Cited by 5 publications

(3 citation statements)

References 7 publications

(23 reference statements)

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“…There have been several studies reporting skin adverse events after COVID-19 vaccination, including PG [30][31][32][33][34]. This is not the case in our patient since her last COVID-19 vaccination was one year prior to her disease relapse.…”

Section: Discussionmentioning

confidence: 54%

Exacerbation of Behcet’s Disease and Pyoderma Gangrenosum Following COVID-19 Infection: A Case Report

Álvarez Pérez,

Vila

2023

Cureus

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Behcet’s disease (BD) and pyoderma gangrenosum (PG) are rare autoimmune inflammatory diseases that have been reported to relapse following COVID-19 infection. BD is a multisystemic syndrome that may involve multiple body organs. PG is a skin disease that can be a part of the skin involvement of BD. We report a 33-year-old woman with BD and PG who developed headaches, arthralgias, and rapidly progressive painful skin ulcers after COVID-19. She had not complained about BD or PG symptoms for two years prior to admission. Treatment at admission comprised infliximab 560 mg every eight weeks, azathioprine 50 mg daily, and low-dose aspirin. Due to the suspicion of neuro BD and the rapid appearance and progression of the ulcers, she was treated with intravenous (IV) methylprednisolone 1000 mg daily three times followed by prednisone at 1 mg/kg/day. Azathioprine was increased to 100 mg bid. Local ulcer care was provided. She was discharged home on the eighth hospital day. The arthralgias were completely gone, and the headaches and skin ulcers had improved. Six months after discharge, she was off prednisone and continued infliximab and azathioprine. She had no headaches or joint pains, and the ulcers had completely healed. One year after admission, BD and PG signs and symptoms had completely disappeared. This case highlights the importance of recognizing that autoimmune diseases may exacerbate COVID-19. Timely management is crucial to prevent complications and morbidity. To our knowledge, this is a rare case report describing BD and PG exacerbation following COVID-19.

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Section: Discussionmentioning

confidence: 54%

Exacerbation of Behcet’s Disease and Pyoderma Gangrenosum Following COVID-19 Infection: A Case Report

Álvarez Pérez,

Vila

2023

Cureus

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“…Several studies over the past 2 years have reported skin side-effects after COVID-19 vaccination, including PG. 17 – 21 To the best of our knowledge, a PG ulcer triggered by COVID-19 vaccination in a patient with UC has not been reported.…”

Section: Discussionmentioning

confidence: 99%

Pyoderma Gangrenosum Triggered by COVID-19 Vaccination in a Patient with Ulcerative Colitis: A Case Report

Kim

Shim

Jeong

et al. 2022

The International Journal of Lower Extremity Wounds

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Pyoderma gangrenosum (PG) is a rare inflammatory skin disease that is difficult to diagnose. PG may be an extra-intestinal manifestation of ulcerative colitis (UC). In recent times, coronavirus disease (COVID-19) vaccines have caused various adverse cutaneous reactions. However, to the best our knowledge, combinations thereof have not been reported. We encountered a case of PG triggered by COVID-19 vaccination in a patient with UC. A 40-year-old woman developed severe pain and an abscess in the dorsum of the left foot after receiving the first dose of the messenger RNA (mRNA)-based Pfizer/BioNTech BNT162b2 COVID-19 vaccine. Severe painful ulcers with purulent necrosis and gaseous gangrene progressed rapidly along the extensor tendons and muscles to the toes and ankle. Although surgical debridement can worsen PG by triggering pathergy, we nonetheless performed wide debridement including partial extensor tenotomy with abscess drainage to prevent progression to pyogenic ankle arthritis and to rescue the toes. Antibiotics, corticosteroids, and anticoagulants were prescribed during surgical wound management via negative pressure therapy. After the lesion improved, the skin and soft tissue defect were covered using a superficial circumflex iliac artery perforator free flap and a split-thickness skin graft. The patient was satisfied with the foot salvage, and could walk unaided (without a brace or cane) from 8 weeks after the final surgery. PG may be rare even in UC patients, but mRNA-based COVID-19 vaccines may find an immunosuppressive niche. A high level of caution and suspicion of skin manifestations after vaccination is essential.

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“…Several cases of PG have been reported as a potential side-effect following SARS-CoV-2 vaccination. [2][3][4][5][6][7] In this case, the Naranjo Adverse Drug Reaction Probability Scale score was 9 out of 13, indicating a definite relationship between the vaccination and the recurrence of PG (Table 1). This association is further strengthened by the recurrence of PG after both doses of the vaccine.…”

mentioning

confidence: 84%

A case of recurrence of pyoderma gangrenosum after COVID‐19 vaccine

Bettolini

Bighetti

Mezzana

et al. 2023

Acad Dermatol Venereol

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A case of recurrence of pyoderma gangrenosum after COVID-19 vaccineDear Editor, Pyoderma gangrenosum (PG) is a rare neutrophilic inflammatory skin condition characterized by painful purulent pustules or enlarging ulcers with raised, undermined and violaceous borders. PG has been associated with various systemic diseases, such as inflammatory bowel disease, monoclonal gammopathy, hematologic disease, inflammatory arthritis, malignancy and hidradenitis suppurativa. 1 There have been several reported cases of occurrences and recurrences of PG after COVID-19 infection and vaccination. In this case report, we describe a patient with a history of PG, which had been in remission for several years prior to vaccination that experienced a recurrence of PG at the same sites as the previous involvement.

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Haemorrhagic bullous pyoderma gangrenosum following COVID‐19 vaccination

Abstract: induces readily detectable morphologic and inflammation-related phenotypic changes in peripheral blood monocytes.

Cited by 5 publications

References 7 publications

Exacerbation of Behcet’s Disease and Pyoderma Gangrenosum Following COVID-19 Infection: A Case Report

Exacerbation of Behcet’s Disease and Pyoderma Gangrenosum Following COVID-19 Infection: A Case Report

Pyoderma Gangrenosum Triggered by COVID-19 Vaccination in a Patient with Ulcerative Colitis: A Case Report

A case of recurrence of pyoderma gangrenosum after COVID‐19 vaccine

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