New‐onset vitiligo after COVID‐19 mRNA vaccination: A causal association?

Abstract

Dear Editor, Given the widespread vaccination of the population with the novel mRNA vaccines against COVID-19, it is of utmost importance to identify any possible adverse effects they may have. In clinical trials with the BNT162b2 COVID-19 mRNA vaccine (Pfizer-ΒioNTech), adverse effects included mostly injection-site reactions, fatigue and headache. 1 Herein, we report a case of vitiligo following vaccination with the BNT162b2 COVID-19 mRNA vaccine (Pfizer/ BioNTech).A 69-year-old male presented with white macules on his face, abdomen, back, and upper and lower limbs that covered approximately 20% of his total body surface area (Figure 1). The lesions had appeared several months before his presentation, 3 days after his second dose of the BNT162b2 COVID-19 mRNA vaccine (Pfizer/BioNTech). The patient reported that the lesions appeared initially on the dorsal area of his hands, progressed to the rest of his body the following month and since then they had remained stable. There was no progression

The Impact of COVID-19 Vaccination on Inflammatory Skin Disorders and Other Cutaneous Diseases: A Review of the Published Literature

“…Regarding other cutaneous diseases developed following COVID-19 vaccination available or reported in literature, we have found nine cases of morphea [ 218 , 219 , 220 , 221 , 222 , 223 ], and 11 cases of vitiligo [ 224 , 225 , 226 , 227 , 228 , 229 , 230 , 231 , 232 , 233 , 234 ]. Other dermatoses have been described, such as chilblains, pityriasis lichenoides et varioliformis acuta, Henoch–Schönlein purpur, lichen striatus or Rowell syndrome, Sweet Syndrome, dermatomyositis, and exanthematous pustulosis.…”

COVID‐19 vaccine–associated vitiligo: A cross‐sectional study in a tertiary referral center and systematic review

“…The systematic review included and analyzed 14 studies. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] We observed hetero- COVID-19 vaccines, regardless of their design, rely on presenting the SARS-CoV-2 spike glycoprotein (SP) antigen to induce immunological memory and neutralizing antibodies. 21 Studies have revealed similarities between fragments of the SARS-CoV-2 SP and mammalian proteins, especially human (Homo sapiens) proteomes.…”

“…In our case series, we analyzed a total of 26 patients with vaccine‐associated vitiligo following COVID‐19 vaccination. The systematic review included and analyzed 14 studies 3–16 . We observed heterogeneity in both patient characteristics and the vaccines implicated in postvaccine vitiligo occurrence.…”

Demographic and clinical feature disparity between progress and non‐progress patients with vitiligo after COVID‐19 vaccination: A cross‐sectional study

“…3 In addition, seven case reports have been reported regarding the newly developed vitiligo following COVID-19 vaccination. 1,[4][5][6][7][8][9] Vitiligo is a disease characterized by the immune-mediated loss of epidermal melanocytes. 10 The relationship between the COVID-19 vaccination and the onset of vitiligo and the instances of autoimmune responses after vaccination suggest that the COVID-19 vaccines may play a role in vitiligo progression, 5 but with limited evidence.…”

“…COVID‐19 vaccine has also been considered a potential trigger of autoimmune reactions such as immune thrombocytopenic purpura (ITP), a phenomenon in which platelets are targeted for destruction by the autoimmune system 3 . In addition, seven case reports have been reported regarding the newly developed vitiligo following COVID‐19 vaccination 1,4–9 . Vitiligo is a disease characterized by the immune‐mediated loss of epidermal melanocytes 10 .…”