Purpuric lesions on the eyelids developed after BNT162b2 mRNA COVID‐19 vaccine: another piece of SARS‐CoV‐2 skin puzzle?

Mazzatenta, Carlo; Piccolo, Vincenzo; Pace, G.; Romano, Ilaria; Argenziano, Giuseppe; Bassi, Andrea

doi:10.1111/jdv.17340

Cited by 31 publications

(40 citation statements)

References 20 publications

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“…6 ). 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ...…”

Section: Discussionunclassified

“…chilblain‐like lesions, morbilliform rashes and vasculitis) SARS‐CoV‐2 vaccines appear to have also the potential to induce a broad spectrum of cutaneous adverse events. 1 , 2 , 3 , 4 , 5 In this review article, 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , …”

Section: Introductionmentioning

confidence: 99%

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Cutaneous findings following COVID‐19 vaccination: review of world literature and own experience

Gambichler

Boms²,

Susok

et al. 2021

Acad Dermatol Venereol

170

254

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There is growing evidence that not only the novel coronavirus disease (COVID‐19) but also the COVID‐19 vaccines can cause a variety of skin reactions. In this review article, we provide a brief overview on cutaneous findings that have been observed since the emerging mass COVID‐19 vaccination campaigns all over the world. Unspecific injection‐site reactions very early occurring after the vaccination are most frequent. Type I hypersensitivity reactions (e.g. urticaria, angio‐oedema and anaphylaxis) likely due to allergy to ingredients may rarely occur but can be severe. Type IV hypersensitivity reactions may be observed, including delayed large local skin lesions (“COVID arm”), inflammatory reactions in dermal filler or previous radiation sites or even old BCG scars, and more commonly morbilliform and erythema multiforme‐like rashes. Autoimmune‐mediated skin findings after COVID‐19 vaccination include leucocytoclastic vasculitis, lupus erythematosus and immune thrombocytopenia. Functional angiopathies (chilblain‐like lesions, erythromelalgia) may also be observed. Pityriasis rosea‐like rashes and reactivation of herpes zoster have also been reported after COVID‐19 vaccination. In conclusion, there are numerous cutaneous reaction patterns that may occur following COVID‐19 vaccination, whereby many of these skin findings are of immunological/autoimmunological nature. Importantly, molecular mimicry exists between SARS‐CoV‐2 (e.g. the spike‐protein sequences used to design the vaccines) and human components and may thus explain some COVID‐19 pathologies as well as adverse skin reactions to COVID‐19 vaccinations.

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Section: Discussionunclassified

Section: Introductionmentioning

confidence: 99%

Cutaneous findings following COVID‐19 vaccination: review of world literature and own experience

Gambichler

Boms²,

Susok

et al. 2021

Acad Dermatol Venereol

170

254

View full text Add to dashboard Cite

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“…A petechial rash of the trunk was even reported in a patient with anaphylactic symptoms [35]. Other forms of purpuric/petechial lesions can be the expression of eczematous pigmented purpura [6] or presenting as an asymptomatic purpura of the eyelid [36] or a brownish rust-like macular erythema of the hands, possibly due to hemosiderin deposition [37]. Purpura can also be arranged in "whip-like" linear or curvilinear streaks as purpura flagellate [38].…”

Section: Vascular Lesionsmentioning

confidence: 99%

Cutaneous Adverse Reactions Associated with SARS-CoV-2 Vaccines

Bellinato

Maurelli

Gisondi

et al. 2021

JCM

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Many patients are receiving SARS-CoV-2 vaccinations, which have been associated with a variety of adverse effects. Cutaneous adverse reactions to SARS-CoV-2 vaccinations have been progressively reported, but they have not been reviewed according to their morphological clinical patterns. The objective of this review was to summarize the existing data concerning the cutaneous adverse reactions following SARS-CoV-2 vaccines and group them according to common morphological and pathogenetic patterns. We reviewed the English language literature up to 15 August 2021, using predefined keywords to identify the relevant studies evaluating cutaneous adverse reactions associated with SARS-CoV-2 vaccines. We search for recurrent morphological patterns sharing clinical signs and symptoms and physio-pathological mechanisms. Timing to onset following the first or booster dose of the vaccine, predisposing conditions, therapeutic management, and outcome were also collected. Among the dermatological manifestations associated with SARS-CoV-2 vaccinations, we distinguished: (1) new onset reactions and (2) flares of preexisting dermatoses. The most common were injection site reactions, affecting 30–70% and generally mild or moderate. Small case series or single case reports included filler reactions, exanthemas, vascular lesions, urticaria, eczematous dermatitis, autoimmune bullous reactions, and severe cutaneous adverse reactions. In addition, the exacerbation of chronic immuno-mediated dermatoses (mainly psoriasis and atopic dermatitis) and reactivations of herpes infection were reported. The cutaneous reactions were generally mild, self-limiting, and resembled common cutaneous drug eruptions and/or COVID-19 skin manifestations.

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“…Similarly, antibodies against spike proteins and activated Th1 cells can cross-react with proteins and antigens in the outer retinal layers, retinal pigment epithelial cells, and large arteries, which may induce AZOOR and AAION [26]. Other possible effects induced by mRNA vaccines include microangiopathy, localized vasculitis, and demyelination, which cause the presence of eyelid purpuric and ecchymotic lesions and abducens nerve palsy [11,30].…”

Section: Mrna Vaccinesmentioning

confidence: 99%

“…The other case was a 67-year-old female who developed ecchymosis on the upper eyelids 10 days after the first dose of BNT162b2 COVID-19 vaccine. All three patients' purpuric eyelid lesions were asymptomatic and resolved spontaneously after 10-15 days [11].…”

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confidence: 92%

Ocular Manifestations after Receiving COVID-19 Vaccine: A Systematic Review

Lee

Huang

2021

Vaccines

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The coronavirus disease 2019 (COVID-19) pandemic has had profound and lasting consequences since 2019. Although vaccines against COVID-19 have been developed and approved under emergency use authorization, various adverse events have also been reported after COVID-19 vaccination. This review was undertaken to help clinicians recognize the possible manifestations and systemic pathogenesis, especially those related to the eye, after receiving COVID-19 vaccination. A systemic search was performed on 22 August 2021 through Embase, Medline, and Cochrane Library for publications on ocular manifestations after COVID-19 vaccination. Two case-control studies/retrospective cohort studies, one cross-sectional study, three case series, sixteen case reports, two images, and seven letters were included. Ocular manifestations after receiving COVID-19 vaccines may appear on the eyelid, cornea and ocular surface, retina, uvea, nerve, and vessel. The ocular manifestations occurred up to forty-two days after vaccination, and vaccine-induced immunologic responses may be responsible. Although the incidence rate of ocular symptoms is considerably lower in the vaccinated subjects than in COVID-19 patients, physicians should be aware of the possible associations between COVID-19 vaccines and ocular symptoms for the early diagnosis and treatment of vision problems or life-threatening complications.

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Purpuric lesions on the eyelids developed after BNT162b2 mRNA COVID‐19 vaccine: another piece of SARS‐CoV‐2 skin puzzle?

Cited by 31 publications

References 20 publications

Cutaneous findings following COVID‐19 vaccination: review of world literature and own experience

Cutaneous findings following COVID‐19 vaccination: review of world literature and own experience

Cutaneous Adverse Reactions Associated with SARS-CoV-2 Vaccines

Ocular Manifestations after Receiving COVID-19 Vaccine: A Systematic Review

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