New‐onset vitiligo following COVID‐19 disease

Abstract

Background: Coronavirus disease 2019 (COVID-19) disease and vaccines have been associated to various skin reactions, which are mostly similar amongst them. New onset of vitiligo and hypopigmentations have been described following COVID-19 vaccination, but never after COVID-19 infection. Objectives: We present the case of a 45-year-old woman, who developed vitiligo 2 weeks after COVID-19 disease. Skin lesions stabilized after 1 month of initial spreading. Results: Vitiligo is a relatively common acquired pigmentary disorder, possibly caused by a T CD8+ cell-mediated autoimmune process, which may be enhanced after the immune activation of COVID-19 disease. Molecular mimicry and bystander activation have been advocated as possible pathogenic mechanisms of vitiligo after COVID-19 vaccination. The same mechanisms may also be involved as possible vitiligo triggers during COVID-19 disease. Conclusions: Clinicians should be aware of this possible autoimmune cutaneous reaction to COVID-19 disease.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Pediatric alopecia areata following COVID‐19 infection

“…4 Also, the theory of an immune pathogenesis of AA is supported by the high association rate with immune-mediated diseases such as thyroiditis, type I diabetes, and vitiligo, which, in turn, have also been associated with COVID-19 infection. [4][5][6] Though a just casual association must be considered, the temporal association evidenced between COVID-19 infection and the new onset of AA of our patients reflects the temporal line of events described in other literature reports and speak in favor of a causative link. 2,3 Lately, the close attention paid to COVID-19 infection permitted to observe numerous possible associations with cutaneous autoimmune manifestations.…”

“…The diagnosis is usually established clinically, as AA is characterized by acute onset, mostly in sharply defined oval-to-round patches of completely bald skin. 5 The patch typically widens centrifugally, ultimately leading to longstanding alopecic areas, showing yellow dots, representative of dilated follicular infundibula filled with keratinous and sebaceous material. 5 The current understanding about AA pathogenesis is that the condition represents an organo-specific autoimmunity against the hair follicles, possibly caused by a loss of immune privilege of hair follicles.…”

“…5 The patch typically widens centrifugally, ultimately leading to longstanding alopecic areas, showing yellow dots, representative of dilated follicular infundibula filled with keratinous and sebaceous material. 5 The current understanding about AA pathogenesis is that the condition represents an organo-specific autoimmunity against the hair follicles, possibly caused by a loss of immune privilege of hair follicles. 4 Indeed, in genetically predisposed individuals, viral infections such as COVID-19 infection may induce oxidative stress resulting in an upregulation of major histocompatibility complex class I (MHC-I) ligands on hair follicles.…”

Cutaneous lupus erythematosus flare with vitiligo-like depigmentation following the AstraZeneca COVID vaccine

“…The vitiligo-like depigmentation is an unusual and interesting feature with some evidence of repigmentation at follow-up. Cases of vitiligo post-COVID vaccination have been reported in the literature 15 and may again be related to type 1 IFN production which is also an early phase in vitiligo pathogenesis. 16 …”

Vitiligo-like Lesions and COVID-19: Case Report and Review of Vaccination- and Infection-Associated Vitiligo

“…To the best of our knowledge, only 16 additional cases linking vitiligo to COVID-19 have been reported in the literature and are summarized in Table 1 , including the ones occurring as a new onset and recrudescence after vaccination and manifestations of the disease in the course of COVID-19 infection [ 1 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Our search revealed 7 male patients affected versus 11 female patients whose age at presentation ranged from 13 to 86 years (mean age 50.625 ± 17.421).…”