Pityriasis-Rosea-like Eruption Following Smallpox Vaccination

Witherspoon, Frank G.

doi:10.1001/archderm.1957.01550190113025

Cited by 11 publications

(3 citation statements)

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“…Cases of PR and PR-like reactions concurrent with COVID-19 have been described as well in the literature. 32 , 66 , 67 There have also been reports of PR or PR-like reactions after vaccination for human papillomavirus, 68 bacillus Calmette-Guérin, 69 smallpox, 70 hepatitis B, 71 pneumococcus, 72 yellow fever, 73 and influenza. 74 , 75 …”

Section: Discussionmentioning

confidence: 99%

Pityriasis following COVID-19 vaccinations: a systematic review

Duzett,

Mercado,

Tasouli-Drakou

et al. 2023

Dermatol Reports

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In the wake of a global COVID-19 pandemic, where innovations in vaccination technology and the speed of development and distribution have been unprecedented, a wide variety of post-vaccination cutaneous reactions have surfaced. However, there has not been a systematic review that investigates pityriasis eruptions and the associated variants following COVID-19 inoculations. A PubMed search using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed to find case reports from the earliest record through November 2022. Data including types of vaccination and pityriasis were extracted and a quality review was performed. 47 reports with 94 patients were found: 64.9% had pityriasis rosea (PR), 3.2% PR-like eruptions, 16.0% pityriasis rubra pilaris (PRP), 7.4% pityriasis lichenoides et varioliformis acuta (PLEVA), 3.2% pityriasis lichenoides chronica (PLC), and 5.3% had reactions described as “atypical”. The top three COVID-19 vaccinations reported were Pfizer-BioNTech (47.9%), Oxford-AstraZeneca (11.7%), and Moderna (8.5%). Pityriasis reactivity was reported most frequently after the Pfizer-BioNTech vaccination, with pityriasis rosea being the most common variant. A large difference was additionally found between the ratio of post-vaccination pityriasis reactions following Pfizer and Moderna vaccinations (5.63), and the ratio of Pfizer’s usage in the United States as of December 28, 2022 relative to that of Moderna (1.59). Further studies with adequate follow-up periods and diagnostic testing will thus need to be performed to elucidate the root of this discrepancy and better characterize the association between different pityriasis reactions and COVID-19 vaccinations.

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Section: Discussionmentioning

confidence: 99%

Pityriasis following COVID-19 vaccinations: a systematic review

Duzett,

Mercado,

Tasouli-Drakou

et al. 2023

Dermatol Reports

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“…PR is uncommon but well-reported in association with both viral infections and vaccinations. 1 Though the mechanism by which PR emerges following vaccination remains poorly understood, several mechanisms have been postulated, including immunologic T cell "distraction" which then permits reactivation of Human Herpes Viruses 6 and/or 7; a hypersensitivity response to the vaccine itself, or some form of molecular mimicry of viral particles yielding T cell over-activation. 5 Among vaccine-associated PR, the smallpox vaccine appears to be particularly implicated.…”

Section: Monkeypox Vaccinationmentioning

confidence: 99%

“…2 While the exact cause is unknown, PR has been linked to immune activation following infection or activation of Human Herpes Viruses 6 and 7, as well as after vaccines, most notably smallpox. 1,2 Monkeypox (MPX) is related to smallpox; both in the orthopox family. MPX has been steadily recognized as a re-emerging public health threat, and the first cases in the United States have been attributed to zoonotic transmission from imported small animals from Ghana.…”

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confidence: 99%

A Case of Pityriasis Rosea Following Monkeypox Vaccination

Beiter

Swigert²,

Elewski³

2022

J of Skin

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Introduction: Pityriasis rosea (PR) is a well-known but uncommon, benign papulosquamous skin condition that often occurs after viral infections or vaccinations. The most commonly implicated vaccine is smallpox. Monkeypox (MPX), a related virus to smallpox within the orthopox family, has recently grown in public health concern. We present here a case of PR following MPX vaccination in an African-American man. Case Report: A 32-year old African-American man presented for evaluation of a one-month history of rash that first appeared as an isolated itching spot on his right mid-back, followed by papular eruptions on his trunk with extremity sparing. He denied recent illnesses, medication use including NSAIDs, or history of similar rash. He did report receiving his first MPX dose about one week prior to rash onset. Pityriasis rosea was diagnosed based on clinical presentation and suspected secondary to the patient’s MPX vaccine course. Conclusion: There are currently two available vaccines for MPX protection in the United States, both of which are vaccinia-based and developmentally related to the smallpox vaccine. Given the known association of smallpox and PR, PR reactions following MPX vaccination may occur.

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Pityriasis Rosea-like Drug Eruption Secondary to Metronidazole

Maize¹

1977

Arch Dermatol

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Pityriasis-Rosea-like Eruption Following Smallpox Vaccination

Cited by 11 publications

References 0 publications

Pityriasis following COVID-19 vaccinations: a systematic review

Pityriasis following COVID-19 vaccinations: a systematic review

A Case of Pityriasis Rosea Following Monkeypox Vaccination

Pityriasis Rosea-like Drug Eruption Secondary to Metronidazole

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