Stevens‐Johnson syndrome induced by Vaxvetria (AZD1222) COVID‐19 vaccine

Aimo, Cristina; Mariotti, Elena Biancamaria; Corrà, Alberto; Cipollini, E. M.; Rose, O Le; Serravalle, C; Pimpinelli, Nicola; Caproni, Marzia

doi:10.1111/jdv.17988

Cited by 9 publications

(10 citation statements)

References 8 publications

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“…Multiple authors have hypothesized that the virotope antigens delivered by COVID‐19 vaccines are expressed on the surfaces of keratinocytes and trigger the activation of cytotoxic CD8+ T‐cells. 2 , 9 , 10 , 11 , 12 , 13 These activated T‐cells then release granulysin, granzyme B, and perforin, which induce pore formation, apoptotic cascades in keratinocytes, and detachment at the dermo‐epidermal junction (DEJ). 2 , 11 , 12 Moreover, these T‐cells secrete significant amounts of cytokines including tumour necrosis factor‐ɑ (TNF‐ɑ) and interferon‐ɣ (IFN‐ɣ), which lead to the overexpression of Fas ligands that also mediate keratinocyte apoptosis.…”

Section: Discussionmentioning

confidence: 99%

Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

Zou

Daveluy

2022

Aust J Dermatology

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Stevens‐Johnson Syndrome (SJS) is a rare but severe skin reaction characterized by blistering and peeling of the skin and ulcerations of mucous membranes; toxic epidermal necrolysis (TEN) is a subset of SJS characterized by the involvement of >30% of the skin. Though previously associated with drugs and infections, discussions on the association between TEN/SJS and COVID‐19 have been limited. We present a review of TEN/SJS after COVID‐19 infection and vaccination. Literature searches were conducted on PubMed and Google Scholar from 2019 to 8/2022. Thirty‐eight articles were selected based on subject relevance, and references within selected articles were also screened for relevance. As of 8/2022, there have been 34 published cases of TEN, SJS, and SJS‐TEN overlap after COVID‐19 infection and vaccination, including 12 cases after vaccination and 22 cases after infection. Multiple authors hypothesize that virotopes or excipients in COVID‐19 vaccines can activate T‐cells or cytokines to induce TEN/SJS. Meanwhile, some hypothesize that COVID‐19 infection induces immune activation that can trigger TEN/SJS or increase susceptibility to drug‐induced TEN/SJS. Treatments for post‐infection and post‐vaccination TEN/SJS vary significantly. We recommend remaining vigilant for this rare and severe potential complication.

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Section: Discussionmentioning

confidence: 99%

Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

Zou

Daveluy

2022

Aust J Dermatology

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“…In addition, cases of SJS/TEN associated with the COVID-19 vaccine have been rarely reported and are summarized in Table 1. [4][5][6][7][8][9][10][11][12] There have been only nine reported cases of SJS/TEN after COVID-19 vaccine. Five of these patients had underlying diseases, such as hyperlipidemia, diabetes mellitus and breast cancer with a history of medication use.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, cases of SJS/TEN associated with the COVID‐19 vaccine have been rarely reported and are summarized in Table 1 . 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 …”

Section: Discussionmentioning

confidence: 99%

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Toxic epidermal necrolysis after first dose of Pfizer‐BioNTech (BNT162b2) vaccination with pharmacogenomic testing

Siripipattanamongkol

Rattanasak

Taiyaitieng

et al. 2022

Pediatric Dermatology

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“…Not only AGEP but also SARS-CoV-2 vaccine-related dermatological manifestations have been reported in large studies. 44,45 While most are non-threatening skin reactions, a couple of severe cutaneous reactions following several SARS-CoV-2 vaccinations include Steven-Johnson's, 46,47 dermatomyositis, 48 IgA vasculitis, 49 pyoderma gangrenosum, 50 extensive rashes with blisterings, 51 TEM 52 and erythema multiforme, 53,54 and lupus erythematosus. 55 Our patient has developed AGEP probably due to terbinafine, as the skin rash occurred a few days after starting the drug.…”

Section: Discussionmentioning

confidence: 99%

What to expect when AGEP is induced by terbinafine? Case report and critical review of the literature

Oliveira

Maia

Leão

et al. 2022

Mycoses

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Background Acute Generalised Exanthematous Pustulosis (AGEP) is a rash with multiple sterile intraepidermal or subcorneal non‐follicular pustules on edematous papules, with a sudden development and rapid evolution, triggered by drugs, vaccination, insect bites, exposure to mercury, and allergens. Objectives and Methods We describe a female patient who developed extensive and abnormally prolonged AGEP following exposure to terbinafine and SARS‐CoV vaccine. A detailed review of terbinafine‐induced‐AGEP cases was performed, with the aim of evaluating if the AGEP criteria would follow a different pattern when the disease is triggered by this drug. A PubMed search helped retrieve all terbinafine‐induced AGEP case reports. AGEP‐specific Sideroff criteria were analysed in terbinafine‐induced cases and compared to other trigger causes. Conclusions When the AGEP causative drug was terbinafine, a delay in recovery was observed, compared to the existing AGEP criteria when other causes are considered. Terbinafine frequently leads to delayed resolution AGEP probably due to the presence of the drug in the skin for several weeks after exposure, even after discontinuation, and the disease severity may be potentialised by additional factors such as concomitant viral infections or vaccination.

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Stevens‐Johnson syndrome induced by Vaxvetria (AZD1222) COVID‐19 vaccine

Cited by 9 publications

References 8 publications

Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

Toxic epidermal necrolysis after first dose of Pfizer‐BioNTech (BNT162b2) vaccination with pharmacogenomic testing

What to expect when AGEP is induced by terbinafine? Case report and critical review of the literature

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