Recurrence of Pyoderma Gangrenosum Potentially Triggered by COVID-19 Vaccination

Abstract

Pyoderma gangrenosum (PG) is a rare inflammatory skin disease of unknown origin. As with other vaccines, COVID-19 vaccines have been associated with many cutaneous reactions. Although COVID-19 vaccination is crucial, it is important for dermatologists and other physicians to be aware of the possible cutaneous reactions that can occur following COVID-19 vaccination. In this report, we describe a 73-year-old woman with a personal history of PG who experienced a recurrence after receiving her second dose of the tozinameran vaccine. Although extremely rare, flares of other inflammatory dermatoses, including lichen planus, have been reported following COVID-19 vaccination. Here we discuss the overlap in pathogenesis of PG and COVID-19, proposing possible mechanisms behind this rare phenomenon.

COVID-19 Vaccine: A Possible Trigger for Pyoderma Gangrenosum

“…The lesion began to develop after the second shot on her left lower leg which was the site of a previous lesion. Our case differs from the case report in Clark and Williams's study [2] in several ways. In our case, the lesion appeared following the first shot of the vaccine.…”

“…Regarding similarities between ours and Clark and Williams's study [2], both patients experienced previous lesions. Furthermore, both patients began to develop cutaneous symptoms such as redness and pain a few hours after the vaccine; however, the ulcer development started shortly after the vaccine shot.…”

“…Regarding the mentioned case in Clark and Williams's study [2], no tests were reported to exclude other causes of the lesion such as autoimmune causes, infection and malignancy. In our case report, numerous medical tests were done.…”

“…In Clark and Williams's study [2], a case report shows a 73-year-old woman who developed a pyoderma gangrenosum lesion after receiving Tozinameran (BNT162b2) COVID-19 vaccine. The lesion began to develop after the second shot on her left lower leg which was the site of a previous lesion.…”

“…Although approved vaccines had minimal to no immediate adverse effects, the long-term effects were still unclear as they require a longer time to appear. Several mild to moderate adverse effects were reported, including cutaneous changes such as pyoderma gangrenosum [2]. Pyoderma gangrenosum is an uncommon ulcerative auto-inflammatory dermatosis [3], a condition in which non-infectious, non-contagious and large painful ulcers develop on the skin [4].…”