Pfizer‐BioNTech SARS‐CoV‐2 mRNA vaccine‐associated erythema multiforme

Abstract

papules, nodules and erythematous patches can be presenting signs of vaccine-associated cutaneous pseudolymphoma. 4 The patient in this case had received various vaccinations throughout her lifetime, including the influenza vaccine on a yearly basis but had not experienced any localized or systemic side effects. It has been proposed that cutaneous pseudolymphoma may represent a reaction to vaccine adjuvants such as aluminium hydroxide. 1 This adjuvant is not found in the Pfizer-BioNtech SARS-CoV-2 mRNA vaccine. 5 By flagging this unique adverse drug reaction, we hope to broaden physician's repertoire of differential diagnoses when presented with SARS-CoV-2-related injection site reactions.

Oral Lesions Following Anti-SARS-CoV-2 Vaccination: A Systematic Review

“…Five additional records [ 18 , 19 , 20 , 21 , 22 ], manually retrieved through the reference lists of the eight articles already included in the present systematic review [ 9 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ] and compliant with currently applied eligibility criteria were considered for the current systematic review.…”

“…Comorbidities and related treatments, reported in 5 cases, were: Leiden factor V mutation in a 31 year old female taking oral contraceptives [ 18 ]; diabetes mellitus and hypertension, treated with amlodipine, teneligliptin, and metformin in a 60-year-old male [ 20 ]; benign pemphigoid of mucous membranes [ 29 ] and celiac disease [ 29 ] in a 55- and a 20-year-old female, respectively; and a 58-year-old female, under sertraline, lorazepam, atorvastatin, metamizole, and penicillin [ 9 ]. Eight participants had a negative history of COVID-19 [ 9 , 18 , 21 , 25 , 29 ], while in one case, the subject became positive for SARS-CoV-2 in the time between the first and second vaccine dose [ 23 ]; in the remaining 7 cases, the previous history of COVID-19 was not specified [ 19 , 20 , 21 , 22 , 24 , 26 , 27 , 28 ].…”

“…Out of the 16 cases diagnosed with oral lesions following anti-SARS-CoV-2 vaccination, 9 cases were diagnosed with oral lesions following the administration of the Pfizer-BioNTech vaccine [ 19 , 24 , 25 , 26 , 28 , 29 ], 2 cases after vaccination with the Moderna vaccine [ 9 , 27 ], and 1 case was described after AstraZeneca [ 18 ], Serum Institute of India [ 20 ], Sinopharm Beijing [ 23 ], and Johnson & Johnson [ 22 ] vaccines, respectively. Oral lesions occurred consequent to the single dose of the Johnson & Johnson vaccine in one case [ 22 ], after the administration of the first dose in a total of 8 cases (5 after the Pfizer-BioNTech [ 19 , 26 , 28 , 29 ], and 1 after the AstraZeneca [ 18 ], Serum Institute of India [ 20 ], and Sinopharm Beijing [ 23 ] vaccines, respectively) and in 7 cases after the administration of thesecond dose (4 after the Pfizer-BioNTech, 2 after Moderna, and 1 after Sinopharm Beijing vaccines, respectively) [ 9 , 24 , 25 , 26 , 27 , 29 ]. In one case [ 21 ], data concerning vaccine type and dose were missing.…”

“…Diagnostic procedures performed were reported in 12 studies [ 9 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ] and comprised: ( n = 8) serological tests, altogether for herpes simplex type 1 and 2, Epstein Barr, human immunodeficiency, hepatitis B and C viruses, cytomegalovirus, mycoplasma pneumoniae, chlamydia pneumoniae, and treponema pallidum; ( n = 1) Nucleic Acid Amplification Test (NAAT); ( n = 2) real-time reverse transcription-polymerase chain reaction (RT-PCR); ( n = 1) nasopharyngeal swab; 8 biopsies; 1 case of removal of amalgam restorations; ( n = 1) direct immunofluorescence test; ( n = 1) skin allergy test; and ( n = 2) maneuvers for evaluation of Nikolsky’s sign. Histological examination was performed in only fourstudies [ 21 , 22 , 25 , 27 ].…”

“…Most of the studies were judged at low [ 19 ] or moderate [ 18 , 23 , 24 , 25 , 26 ] risk of bias, and 1 study was characterized by a severe [ 20 ] risk of bias ( Table S1 is available as Supplementary Data ), mainly due to missing data, measurement of outcomes, and selection of the reported results.…”