Widespread purpura annularis telangiectodes following mRNA SARS‐CoV‐2 vaccine

Abstract

that CoronaVac can act as an inciting factor that activates the same pathway of EM leading to a type III or IV of hypersensitivity either by the vaccine itself or to its components. 8 Erythema multiforme following vaccination is rare, just as other major adverse events and should not discourage the use of vaccines. Also, the rarity of the disease makes it hard to establish a causal link. But since we are just at the beginning about learning of the novel anti-SARS-CoV-2 vaccines, it is important to be aware about its possible cutaneous adverse reactions.

A Systematic Review of Histopathologic Surveys on Mucocutaneous Biopsies in Patients Developed COVID-19 Vaccine-Related Dermatologic Manifestations

“…In multiple studies, histopathologic evaluation of vasculitis lesions showed leukocyte infiltration into the endothelia resulting in inflammation and swelling. [9][10][11][12][13][14][15][16][17][18][19] Subsequently, perivascular mixed lymphocytes, neutrophils, and occasional eosinophils plus marked debris and red blood cells (RBCs) extravasations were reported, which was consistent with leukocytoclastic vasculitis 10,11,13,14,16,[18][19][20][21][22][23][24][25][26][27] ; these findings were also observed in 2 other cases: a figurate purpuric eruption 28 and a pigmented purpuric dermatosis. 29 Furthermore, immunofluorescence microscopy was performed on some samples, and deposition of C3, fibrin, fibrinogen, immunoglobulin M, and IgA were reported.…”

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

“…In cases where the same sample was used for more than one study, all studies were reviewed to determine the extent to which there may be duplication in the reported outcomes between studies. The full text of selected studies was reviewed, and data on demographics, article type, number of reported cases with cutaneous involvement, vaccine, and rash type (morphology) were extracted from articles texts, tables, figures, and summarized through a descriptive table (Table 1)…”

“…),13 Moderna (McMahon et al 138 ), 6 Pfizer (McMahon et al 138 ), 2 Astrazeneca (McMahon et al 138 ), 3 Not specified (McMahon et al138 ), 2 Pfizer (Busto-Leis et al20 ), 1 Pfizer (Carballido-V azques et al22 ), 1 Coronavac (Akdas et al26 ), 2 Pfizer (Cyrenne et al40 ), 1 Pfizer (Abdullah et al56 ), 1 Covishield (Adya et al64 ), 2 Pfizer (Marcantonio-Santa Cruz et al82 ), 1 Moderna (Larson et al92 ), 14 Pfizer (Temiz et al110 ), 17 Coronavac (Temiz et al110 ), 1 Coronavac (Akdas et al112 ), 8 Coronavac (Durmaz et al118 ), 1 Pfizer (Cohen et al128 ), 1 Pfizer (Tihy et al130 ), 1 Pfizer (Choi et al135 ), 2 Not specified (McMahon et al138 ), 1 Covishield (Mehta et al151 ), 1 Astrazeneca (Leerunyakul et al156 ), 1 Not specified (Bostan et al160 ), 2 Coronavac (Rerknimitr et al175 ), 1 Pfizer (Niebel et al179 ), 1 Astrazeneca (Niebel et al179 ), 3 Not specified(Grieco et al 192 ), 1 Astrazeneca (Yu et al204 ), 1 Astrazeneca (Pedrazini et al208 ), 2 Not specified (Huang et al218 ). 2 Pfizer (Lam et al15 ), 3 Moderna (McMahon et al138 ), 5 Pfizer (McMahon et al138 ), 1 Pfizer (Cohen et al128 ), 1 Moderna (Malayala et al33 ), 3 Pfizer (Mazzatenta et al47 ), 1 Pfizer (Krajewski et al51 ), 1 Covaxin (Kharkar et al57 ), 1 Pfizer (Falkenhain-L opez et al79 ), 1 Pfizer (Nastro et al98 ), 1International Journal of Dermatology 2022, 61, 1187-1204 ª 2022 the International Society of Dermatology.…”

Purpuric dermatosis and lymphocytic vasculopathy following SARS‐CoV ‐2 vaccination: Report of two patients

“…Falkenhain-Lopez et al first reported a case of widespread purpura annularis telangiectodes shortly after receiving mRNA SARS-CoV-2 vaccine, which histologically demonstrated dermal perivascular lymphocytic infiltration with no evidence of fibrinoid necrosis, and fibrin deposition. 5 Atak et al reported a case of pigmented purpuric dermatosis following administration of BNT162B2 mRNA COVID-19 vaccine with histologic features of epidermal spongiosis, and lymphocytic exocytosis with dermal perivascular lymphocytic infiltration, endothelial swelling, and red blood cell extravasation. 6 It is suggested that the underlying mechanism is related to endothelial damage by the virus, and the inflammatory infiltrates.…”