Clinical and pathologic correlation of cutaneous COVID-19 vaccine reactions including V-REPP: A registry-based study.
AZD1222
Ad26.COV2.S
BNT162b2
COVID-19
Johnson & Johnson Janssen
Moderna
Oxford-AstraZeneca
Pfizer-BioNTech
SARS-CoV-2
Stevens-Johnson syndrome
bullous pemphigoid
chilblains
delayed large local
dermal hypersensitivity reaction
dermatology
dermatopathology
erythema multiforme
erythromelalgia
lichen planus
mRNA-1273
morbilliform
papular
papulosquamous
pathology
pernio
pityriasis rosea
psoriasis
registry
urticaria
vaccine
zoster
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
received:
30
06
2021
revised:
22
08
2021
accepted:
02
09
2021
pubmed:
14
9
2021
medline:
11
1
2022
entrez:
13
9
2021
Statut:
ppublish
Résumé
Cutaneous reactions after COVID-19 vaccination have been commonly reported; however, histopathologic features and clinical correlations have not been well characterized. We evaluated for a history of skin biopsy all reports of reactions associated with COVID-19 vaccination identified in an international registry. When histopathology reports were available, we categorized them by reaction patterns. Of 803 vaccine reactions reported, 58 (7%) cases had biopsy reports available for review. The most common histopathologic reaction pattern was spongiotic dermatitis, which clinically ranged from robust papules with overlying crust, to pityriasis rosea-like eruptions, to pink papules with fine scale. We propose the acronym "V-REPP" (vaccine-related eruption of papules and plaques) for this spectrum. Other clinical patterns included bullous pemphigoid-like (n = 12), dermal hypersensitivity (n = 4), herpes zoster (n = 4), lichen planus-like (n = 4), pernio (n = 3), urticarial (n = 2), neutrophilic dermatosis (n = 2), leukocytoclastic vasculitis (n = 2), morbilliform (n = 2), delayed large local reactions (n = 2), erythromelalgia (n = 1), and other (n = 5). Cases in which histopathology was available represented a minority of registry entries. Analysis of registry data cannot measure incidence. Clinical and histopathologic correlation allowed for categorization of cutaneous reactions to the COVID-19 vaccine. We propose defining a subset of vaccine-related eruption of papules and plaques, as well as 12 other patterns, following COVID-19 vaccination.
Sections du résumé
BACKGROUND
Cutaneous reactions after COVID-19 vaccination have been commonly reported; however, histopathologic features and clinical correlations have not been well characterized.
METHODS
We evaluated for a history of skin biopsy all reports of reactions associated with COVID-19 vaccination identified in an international registry. When histopathology reports were available, we categorized them by reaction patterns.
RESULTS
Of 803 vaccine reactions reported, 58 (7%) cases had biopsy reports available for review. The most common histopathologic reaction pattern was spongiotic dermatitis, which clinically ranged from robust papules with overlying crust, to pityriasis rosea-like eruptions, to pink papules with fine scale. We propose the acronym "V-REPP" (vaccine-related eruption of papules and plaques) for this spectrum. Other clinical patterns included bullous pemphigoid-like (n = 12), dermal hypersensitivity (n = 4), herpes zoster (n = 4), lichen planus-like (n = 4), pernio (n = 3), urticarial (n = 2), neutrophilic dermatosis (n = 2), leukocytoclastic vasculitis (n = 2), morbilliform (n = 2), delayed large local reactions (n = 2), erythromelalgia (n = 1), and other (n = 5).
LIMITATIONS
Cases in which histopathology was available represented a minority of registry entries. Analysis of registry data cannot measure incidence.
CONCLUSION
Clinical and histopathologic correlation allowed for categorization of cutaneous reactions to the COVID-19 vaccine. We propose defining a subset of vaccine-related eruption of papules and plaques, as well as 12 other patterns, following COVID-19 vaccination.
Identifiants
pubmed: 34517079
pii: S0190-9622(21)02442-7
doi: 10.1016/j.jaad.2021.09.002
pmc: PMC8431833
pii:
doi:
Substances chimiques
COVID-19 Vaccines
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
113-121Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Informations de copyright
Copyright © 2021 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest Drs Freeman, Hruza, Rosenbach, Lipoff, Fox, and Thiers are members of the American Academy of Dermatology COVID-19 Ad Hoc Task Force. Dr French is the President and Dr Lim a board member of the International League of Dermatological Societies. Dr Thiers is the Immediate Past President of the American Academy of Dermatology. Dr Freeman is an author of COVID-19 dermatology for UpToDate. Drs McMahon, Kovarik, Damsky, Nazarian, Desai, and Blumenthall and Authors Tyagi, Chamberlin, and Fathy have no conflicts to declare.