Recurrence of cutaneous T‐cell lymphoma post viral vector COVID‐19 vaccination

Abstract

The diagnosis remains probable despite the strong temporal relationship because after literature review with the keywords 'SARS-CoV-2', 'Vaccine', 'COVID-19', 'Angiomatosis', 'Haemangiomatosis', 'Cherry' and/or 'Angiomas', no other articles describe true eruptive angiomas after any SARS-CoV-2 vaccine.The pathogenesis of this skin disorder remains unclear. Among the various possibilities, we proposed an HVV-8 reactivation elicited by the vaccination, 1,5 but a real-time PCR requested to search for herpesvirus DNA on cutaneous samples resulted negative.Cells exposing angiotensin-converting enzyme 2 (ACE2) could be altered by circulating spike proteins, probably affecting the ACE2 pathway. 6 Inflammation or increased angiotensin II levels could stimulate the proliferation of predisposed endothelial cells of the skin, causing angiomas; the latter mechanism is also proposed in infantile haemangiomas. 7 Still, experimental studies have not shown significant alterations in the angiotensin II pathway in patients with COVID-19. 8 We believe in a dysregulation of the neuropilin-1 (NRP-1) proteins cascade 9 as a plausible mechanism. Spike protein portions could bind to the NRP-1 and interfere with the VEFG-R, which has been already described to cause cherry angiomas proliferation when dysregulated. This interaction could recall the side effects produced by ramucirumab and other VEGF-R inhibitors. 10 In conclusion, in this case report, we aimed to raise awareness of the increasing variety and complexity of viral, paraviral and vaccine skin reactions induced by the immune response to the genetic material related to the SARS-CoV-2. By sharing this case, we hope that physicians can be aware of the increasing spectrum of AEDs related to these vaccines skin manifestations, however harmless and self-limiting.

Lymphomatoid papulosis (LyP) after AZD1222 and BNT162b2 COVID‐19 vaccines

“…4 Panou and colleagues reported the recurrence of type A LyP following vaccination with viral vector COVID-19 vaccination in a patient with a history of LyP and mycosis fungoides who had been in remission for 10 years. 3 Our cases further support the etiological correlation between COVID-19 immunization and CD30+ T-cell cutaneous exacerbation. Interestingly, both cases were type D LyP, a rare, newly recognized histologic variant.…”

“…Lymphomatoid reactions, 1 recurrence of primary cutaneous CD30‐positive lymphoproliferative disorder 2 cutaneous T‐cell lymphoma, 3 and primary cutaneous anaplastic large‐cell lymphoma following COVID‐19 vaccination have been reported 4 . Panou and colleagues reported the recurrence of type A LyP following vaccination with viral vector COVID‐19 vaccination in a patient with a history of LyP and mycosis fungoides who had been in remission for 10 years 3 . Our cases further support the etiological correlation between COVID‐19 immunization and CD30+ T‐cell cutaneous exacerbation.…”

“…To the best of our knowledge, here we have reported the first cases of new‐onset LyP after the COVID‐19 vaccination. Lymphomatoid reactions, 1 recurrence of primary cutaneous CD30‐positive lymphoproliferative disorder 2 cutaneous T‐cell lymphoma, 3 and primary cutaneous anaplastic large‐cell lymphoma following COVID‐19 vaccination have been reported. 4 Panou and colleagues reported the recurrence of type A LyP following vaccination with viral vector COVID‐19 vaccination in a patient with a history of LyP and mycosis fungoides who had been in remission for 10 years.…”

Hematologic Malignancies Diagnosed in the Context of the mRNA COVID-19 Vaccination Campaign: A Report of Two Cases

“…Similar findings were reported in another study conducted on patients diagnosed with B-cell non-Hodgkin lymphoma [ 15 ]. After billions of vaccinations, only isolated cases of exacerbation or recurrence of pre-existing hematologic malignancies shortly after COVID-19 vaccination have been reported for both viral vector- and mRNA-based vaccines [ 16 , 17 ]. Even if in a worldwide vaccination campaign such isolated events can occur coincidentally, they must be reported, thus inviting additional investigations on the particular mechanisms of action of COVID-19 vaccines in this category of patients.…”

SARS‐CoV‐2 vaccine‐related cutaneous manifestations: a systematic review

“…), 4 Not specified (McMahon et al138 ) 37. ), 1 Pfizer (Mintoff et al150 ), 2 Astrazeneca (Panou et al170 ), 1 Not specified(Grieco et al 192 ) 97. ), 1 Covishield (Nagrani et al106 ), 1 Moderna (Pesqu e et al154 ), 1 Pfizer (Ricardo et al168 ), 1 Pfizer (Song et al200 ) 69.…”