Occurrence of erythema multiforme following COVID-19 vaccination: a review

Abstract

The fast development of vaccines against the novel coronavirus disease is among the most critical steps taken to control this potentially fatal viral disease. Like other vaccines, the coronavirus disease 2019 (COVID-19) vaccines can also cause unwanted reactions. Erythema multiforme (EM) is among the oral mucocutaneous side effects of COVID-19 vaccines. This study aimed to comprehensively review the reported cases of EM since the global onset of COVID-19 vaccination. Data from 31 relevant studies regarding the type and dose of COVID-19 vaccines administered, time of initiation of symptoms, age, and gender of patients, site of involvement, patients’ medical history, and treatment options were extracted. In total, 90 patients were identified with EM as a side effect of COVID-19 vaccination across studies. EM had the highest frequency after receiving the first dose of mRNA vaccines in older individuals. The first symptoms of EM appeared in less than 3 days in 45% and after 3 days in 55% of patients. EM is not a common side effect of COVID-19 vaccination, and fear of its occurrence should not impede vaccination.

Recurrent Erythema Multiforme Major Following COVID-19 Infection

“…Some studies have also shown an association between EM and COVID-19 vaccination; however, this is unlikely in our case given that the patient presented with a year of recurrent EM rashes before being vaccinated. EM after COVID-19 vaccination in the majority of the patient population occurred three days after vaccination, which did not occur in this case [ 6 ].…”

A comprehensive review of oral microenvironment changes and orofacial adverse reactions after COVID‐19 vaccination: The good, the bad, and the ugly

“…• Autoimmunologic reaction 89 • Mucocutaneous adverse reaction 90 • White plaques 70 Attenuated or inactivated virus Sinopharm (BBIBP-CorV) -Autoimmunologic reaction. 91 erythema multiforme 92 • Erosions and erythematous lesions 91 mRNA-based vaccines…”

The pathophysiology and clinical phenotypes of COVID-19 mRNA vaccine-related cutaneous adverse reactions: A narrative review

“…Vaccine-induced EM has been reported to be caused by measles-mumps-rubella (MMR), influenza, diphtheria-pertussis-tetanus (DPT) and hepatitis B vaccines. Yousefian and Khadivi [99] collected 90 cases with EM after COVID-19 vaccination from 31 articles published by April 2022. They reported that the mean age was 51 years, the prevalence in females was twice than that in males, EM appeared after the 1st dose (44%) and 2nd dose (30%), respectively, in which Moderna-1273 (32%) and BNT126b2 (47%) were used.…”