Leukocytoclastic vasculitis as a cutaneous manifestation of <scp>ChAdOx1 nCoV</scp>‐19 corona virus vaccine (recombinant)

Sandhu, Sunmeet; Bhatnagar, Anuj; Kumar, Harish; Dixit, Pradipkumar; Paliwal, Gourang; Suhag, Devinder Kumar; Patil, Chetan; Mitra, Debdeep

doi:10.1111/dth.15141

Cited by 24 publications

(24 citation statements)

References 15 publications

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“…Only one had cryoglobulinemia. 7 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 36 , 37 Nastro et al 21 reported an 84‐year‐old woman, with history of chronic kidney disease and depressive disorder, developed burning pain on the distal part of right leg and foot, followed by ipsilateral multiple non‐confluent purpuric papules and vesicles few hours after she received the first dose of Pfizer‐BioNTech COVID‐19 vaccine. PCR of a skin swab for varicella‐zoster virus (VZV) resulted positive, and VZV IgM and IgG antibodies were positive.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty cases of COVID‐19‐vaccine triggered‐LCV were noted; three with an elevated anti‐Spike SARS CoV‐2 Antibody titer, two of them had no history of COVID‐19.Oral mucosal involvement was noted in one case. Only one had cryoglobulinemia 7,18–33,36,37 . Nastro et al 21 reported an 84‐year‐old woman, with history of chronic kidney disease and depressive disorder, developed burning pain on the distal part of right leg and foot, followed by ipsilateral multiple non‐confluent purpuric papules and vesicles few hours after she received the first dose of Pfizer‐BioNTech COVID‐19 vaccine.…”

Section: Resultsmentioning

confidence: 99%

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SARS‐CoV‐2 vaccination‐induced cutaneous vasculitis: Report of two new cases and literature review

Abdelmaksoud

Wollina

Temiz

et al. 2022

Dermatologic Therapy

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Currently the most powerful tool in combating the COVID‐19 pandemic is vaccination against SARS‐CoV‐2. A growing percentage of the world's population is being vaccinated. Various vaccines are worldwide on the market. Several adverse reactions have been reported as a part of post‐marketing surveillance of COVID‐19 vaccines. Among the possible adverse events, cutaneous vasculitis has occasionally been reported. We present a narrative review on cutaneous vasculitis related to COVID‐19‐vaccination to summarize clinical findings, histopathology, treatment and outcome. We searched for “COVID vaccine”, “COVID vaccination” AND “cutaneous vasculitis” in PUBMED. Articles in English have been selected, from inception to December 2021, and analyzed for patient's characteristics, type of vaccine, time of appearance of cutaneous vasculitis and clinico‐histopathologic type. Treatment and outcome have also been considered in this narrative review. Two new unpublished cases of ours were added. Cutaneous vasculitis is a rare adverse event to COVID‐19 vaccination. It has been observed with mRNA and adenovirus‐vector vaccines. IgA vasculitis, lymphocytic and ANCA‐associated vasculitis, leukocytoclastic and urticarial vasculitis have been reported. This adverse event can occur after first or second shot. Most cases run a mild to moderate course. Cornerstone of medical treatment are systemic corticosteroids. Complete remission could be achieved in most patients. Vasculitis may not be considered as a contraindication of vaccination, being uncommonly reported and shows a favorable prognosis. The benefit of the vaccination remains high especially for immunocompromised patients. COVID‐vaccine induced vasculitis is important in the differential diagnosis of purpuric and vasculitis disorders.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

SARS‐CoV‐2 vaccination‐induced cutaneous vasculitis: Report of two new cases and literature review

Abdelmaksoud

Wollina

Temiz

et al. 2022

Dermatologic Therapy

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“…Three of five erythema multiforme cases were associated with the mRNA-1273 vaccine [ 1 , 62 , 63 ]. New onset of prurigo nodularis [ 17 ], radiation recall dermatitis [ 64 ], symmetrical drug-related intertriginous and flexural exanthema (SDRIFE)-like eruption [ 65 ], Stevens-Johnson syndrome/toxic epidermal necrolysis [ 66 , 67 , 68 ], Sweet’s syndrome [ 69 , 70 ], vitiligo [ 71 ], vasculitis [ 50 , 72 , 73 ], livedo racemosa [ 27 ], fixed drug eruption [ 27 ], pityriasis rubra pilaris-like eruption [ 74 ], and facial pustular neutrophilic eruption [ 75 ] have been reported post-vaccination. All SJS and Sweet’s syndrome cases were managed successfully.…”

Section: Resultsmentioning

confidence: 99%

Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review

et al. 2022

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Because of the increasing emergence of cutaneous reactions from COVID-19 vaccines worldwide, we investigated the published reports of these complications. We searched the PubMed, Google Scholar, and Scopus databases and the preprint server bioRxiv for articles on cutaneous complications linked to mRNA-1273 (Moderna), BNT162b2 (Pfizer–BioNTech), and AZD1222 (AstraZeneca–Oxford University) vaccines published until 30 September 2021. Eighty studies describing a total of 1415 reactions were included. Cutaneous reactions were more prevalent in females (81.6%). Delayed large local reactions were the most common complication (40.4%), followed by local injection site reactions (16.5%), zoster (9.5%), and urticarial eruptions (9.0%). Injection site and delayed large local reactions were predominantly caused by the mRNA-1273 vaccine (79.5% and 72.0%, respectively). BNT162b2 vaccination was more closely linked to distant reactions (50.1%) than mRNA-1273 (30.0%). Zoster was the most common distant reaction. Of reactions with adequate information for both vaccine doses, 58.3% occurred after the first dose only, 26.9% after the second dose only, and 14.8% after both doses. Overall, a large spectrum of cutaneous reaction patterns occurred following the COVID-19 vaccination. Most were mild and without long-term health implications. Therefore, the occurrence of such dermatologic complications does not contraindicate subsequent vaccination.

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“…The exact pathogenesis of vaccination-associated leukocytoclastic vasculitis has yet to be determined, but SARS-CoV-2 vaccine might result in the activation of autoreactive B/T cells, antibody formation, and immune complex deposition within small vessels, leading to activation of the complement system and recruitment of leukocytes [ 4 , 6 , 7 , 9 , 10 ]. The responsible particle as an antigen for such reactions is unknown, however inflammatory response to vaccine component encoding SARS‐CoV‐2 spike glycoprotein, targeting endothelium and resulting in small-vessel vasculitis, could be hypothesized [ [11] , [12] , [13] ].…”

Section: Discussionmentioning

confidence: 99%

Leukocytoclastic vasculitis (cutaneous small-vessel vasculitis) after COVID-19 vaccination

Fiorillo¹,

Pancetti²,

Cortese³

et al. 2022

Journal of Autoimmunity

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Vaccinations may induce cutaneous adverse events, due to nonspecific inflammation or immuno-mediated reactions. Several types of vasculitis have been observed. We report on a 71-year-old woman who developed cutaneous small-vessel vasculitis after the second dose of Vaxzevria COVID-19 vaccination, showing leukocytoclastic vasculitis on histopathological examination of a skin biopsy. Cutaneous small-vessel vasculitis is a rare condition which can be idiopathic or secondary to underlying infections, connective tissue disorders, malignancy, and medications. The pathogenesis involves immune complex deposition in small blood vessels, leading to activation of the complement system and recruitment of leukocytes. Exacerbation of small-vessel vasculitis has been reported following the administration of various vaccines, particularly influenza vaccine. It is expected that SARS-CoV-2 vaccine results in the activation of B- and T-cells and antibody formation. We hypothesize that leukocytoclastic vasculitis caused by immune complex deposition within cutaneous small vessels could be a rare side effect of Vaxzevria COVID‐19 vaccination.

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Leukocytoclastic vasculitis as a cutaneous manifestation of ChAdOx1 nCoV‐19 corona virus vaccine (recombinant)

Cited by 24 publications

References 15 publications

SARS‐CoV‐2 vaccination‐induced cutaneous vasculitis: Report of two new cases and literature review

SARS‐CoV‐2 vaccination‐induced cutaneous vasculitis: Report of two new cases and literature review

Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review

Leukocytoclastic vasculitis (cutaneous small-vessel vasculitis) after COVID-19 vaccination

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