<scp>COVID</scp>‐19 induced pityriasis rubra pilaris: A superantigenic disease?

Aromolo, Italo Francesco; Pisapia, Armando; Riva, Davide; Barberi, Francesco; Marzano, Angelo Valerio; Moltrasio, Chiara; Romagnuolo, Maurizio

doi:10.1111/jdv.18556

Cited by 9 publications

(17 citation statements)

References 8 publications

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“…Within the English literature, PRP has been reported in association with measles-mumps-rubella, diphtheria-tetanuspertussis, oral polio, and influenza (Vaxigrip Tetra) vaccines. [8][9][10] Recently, there have been rare reports of PRP developing after COVID-19 infection, [11][12][13][14][15] similar to those documented cases of PRP in the setting of infection with other non-HIV viruses. 16,17 We add to the literature body of PRP as a cutaneous side effect to the COVID-19 vaccine (all cases reported to date are summarized in Table 1).…”

Section: Discussionmentioning

confidence: 96%

Pityriasis Rubra Pilaris After Moderna COVID-19 Vaccination: A Case Report and Literature Review

Liu¹,

Dai

Nagarajan³

et al. 2023

The American Journal of Dermatopathology

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To date, over 60% of the world's population has received at least 1 dose of coronavirus disease 2019 (COVID-19) vaccination, with over 12 billion doses administered globally. Commonly reported adverse effects of COVID-19 vaccination include fever, headache, myalgia, and injection site reactions. The spectrum of documented cutaneous reactions after COVID-19 vaccination is broad; however, pityriasis rubra pilaris (PRP) or PRP-like eruption secondary to COVID-19 vaccine is exceedingly rare, with only 17 cases previously reported to date in the English literature. In this article, we describe an additional case of COVID-19 vaccination-associated PRP in a 50-year-old woman with a history of metastatic breast carcinoma, who developed a widespread cutaneous eruption characteristic of PRP, including palmoplantar keratoderma, 10 days after her third dose of Moderna COVID-19 vaccine. Punch biopsy specimen showed epidermal hyperplasia with overlying hyperkeratosis, alternating orthokeratosis and parakeratosis and focal follicular plugging, supporting the diagnosis of PRP. The patient improved within weeks of initiating oral acitretin and topical steroids, with resolution achieved after 3 months of continued therapy. To the best of our knowledge, this is the third reported case of Moderna COVID-19 vaccination-associated PRP and collectively the 18 th after the administration of all COVID-19 vaccines currently available, including Pfizer-BioNTech, and AstraZeneca.

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Section: Discussionmentioning

confidence: 96%

Pityriasis Rubra Pilaris After Moderna COVID-19 Vaccination: A Case Report and Literature Review

Liu¹,

Dai

Nagarajan³

et al. 2023

The American Journal of Dermatopathology

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“…7 The main characteristics of this subtype are an acute course preceded by symptoms of an infection, no clinical or laboratory abnormalities except those due to the initial infection and scarlatiniform erythema followed by follicular papules with the appearance of classical juvenile PRP weeks later. 3,7 The prognosis of this PRP subgroup is typically good and does not tend to reappear. Subsequently, Ferrándiz-Pulido et al, suggested that postinfectious PRP should be considered a superantigenmediated dermatosis, according to the clinical similarity of the prodromic scarlatiniform phase with other skin disorders mediated by superantigen, such as Kawasaki disease.…”

Section: Discussionmentioning

confidence: 99%

“…1 Some viruses such as cytomegalovirus, Epstein-Barr virus, varicella zoster, human immunodeficiency virus (HIV) and, more exceptionally, SARS-CoV-2, have been reported as infectious triggers of PRP. [1][2][3][4] We report an adult case of PRP following COVID-19 infection.…”

Section: Introductionmentioning

confidence: 97%

Acute pityriasis rubra pilaris triggered by COVID‐19

Soto‐García,

Oro‐Ayude,

Álvarez

et al. 2023

JEADV Clinical Practice

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Pityriasis rubra pilaris (PRP) can be triggered by viruses, such as cytomegalovirus, Epstein‐Barr virus, varicella zoster, human immunodeficiency virus and, more exceptionally, SARS‐CoV‐2. We report an additional case of PRP following COVID‐19 infection. Given the existing literature and the close temporal association, we suggest a possible causal relationship. We speculate that an altered immune response with a genetic predisposition for PRP may have played a role in our patient. We highlight the development of PRP as part of the spectrum of COVID‐19 skin‐related conditions.

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“…[2][3][4][5] In addition, several patients with SARS-CoV-2 infection developed subsequently RPR have been reported. 4,6 There is still controversy over the causal relationship between SARS-CoV-2 vaccines and RPR. These events may result from upregulated inflammatory immunological pathways, or from cross between viral or adjuvant molecules and self-antigens.…”

Section: Pityriasis Rubra Pilaris Following Inactivated Sars-cov-2 Va...mentioning

confidence: 99%