New onset of mainly guttate psoriasis after COVID‐19 vaccination: a case report

Abstract

Our case series is limited by the absence of a control group and the retrospective analysis that was conducted. Large-scale prospective studies and pharmacovigilance monitoring are warranted to clarify the risks of VZV reactivation for all available SARS-CoV-2 vaccines. It should be determined whether all SARS-CoV-2 share a similar risk for this adverse reaction and should some of them be relatively safer in this regard, consideration should be given when choosing a vaccine for individuals most at risk for VZV reactivation (e.g. elderly, immunosuppression).

Cutaneous Adverse Reactions Associated with SARS-CoV-2 Vaccines

“…Two middle-aged women developed a rosacea-like eruption 4 to 5 days after Ad26.CoV2.S and BNT162b2 vaccination [57]. In some patients, COVID vaccination may induce a new onset of psoriatic disease, presenting as chronic plaque psoriasis [58,59], palmoplantar psoriasis [60], guttate psoriasis [61], generalized pustular psoriasis [62], and even pityriasis rubra pilaris [63].…”

Reply to “Psoriasis exacerbation after COVID‐19 vaccination: report of 14 cases from a single centre” by Sotiriou E et al.

“…2,3 In the literature, there are only few cases reporting the worsening of psoriasis after COVID-19 vaccine. [7][8][9][10] In our opinion, systemic treatment may reduce the risk of psoriasis flares after COVID-19 vaccination by the protection against the inflammatory process, which can cause the worsening of the disease. Hence, patients undergoing topical treatment for psoriasis have a higher risk of psoriatic flares compared with patients treated with systemic drugs.…”

Vaccines Against SARS-CoV-2 in Psoriasis Patients on Immunosuppressive Therapy: Implications of Vaccination Nationwide Campaign on Clinical Practice in Italy

“…Wide range of cutaneous side effects are being reported with different types of SARS-CoV-2 vaccines including early-onset or delayed-type local injection reactions, maculopapular rash, erythema multiforme, pernio and urticaria. [48] Exacerbation of chronic inflammatory skin disorders such as psoriasis has also been recently described [49][50][51][52][53].…”

“…Lehhman et al reported a new-onset guttate psoriasis after the BNT162b2 mRNA vaccine in a 79-year-old female, whose rash started 10 days after the first dose and flared up after the second dose [50]. Onsun et al reported a case of generalized pustular psoriasis developed 4 days after the first dose of the inactivated SARS-CoV-2 vaccine in a 72-year old man who had plaque psoriasis treated only with topical treatments [51].…”

“…In our opinion, these recommendations should be extended to all patients with psoriasis, both those receiving treatment and those not currently being treated. Finally, possible exacerbations of psoriasis in patients undergoing treatment should not, in our opinion, be a reason to renounce vaccination, also because the cases that have occurred and are reported in the literature have all resolved without complications[49][50][51][52][53].…”