Oral erythema multiforme after Pfizer-BioNTech COVID-19 vaccination: a report of four cases.


Journal

BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684

Informations de publication

Date de publication:
24 03 2022
Historique:
received: 27 10 2021
accepted: 16 03 2022
entrez: 25 3 2022
pubmed: 26 3 2022
medline: 30 3 2022
Statut: epublish

Résumé

The 2019 Coronavirus disease (Covid-19) has affected thousands of people worldwide. To date, vaccines appear to be the only method to prevent and reduce mortality. Four vaccinations have been outwardly approved by European Medicine Agency (EMA) in Europe: BNT162b2 (Comirnaty-BioNTech/Pfizer), mRNA-1273 (Spikevax-Moderna), ChAdOx1 (VaxzevriaAstrazeneca), and Ad26.COV2-S (Janssen-Johnson&Johnson). After vaccination, local and systemic adverse effects can occur. Cutaneous reactions like urticaria, local injection site pain, morbilliform rash have been documented after vaccination. We report four cases of oral erythema multiforme flare arising after BNT162b2 vaccination administration. All the patients denied previous erythema-like and herpetic manifestations history. Two of the reported cases (number 1 and 2) presented with both oral and cutaneous lesions, while cases 3 and 4 showed only oral manifestations. Three of the cases presented the erythema after the first vaccination dosage administration, only one case reported lesions after the second vaccination dosage administration. All the cases were treated with prednisone via oral administration and topical 0.05% clobetasol ointment. The present reports represent some of the few cases of erythema multiforme occurring as a side effect of the BNT162b2 COVID-19 vaccination. The causal role of the vaccine for the erythema multiforme has not been proven yet; nevertheless, it is not uncommon for medications to trigger this disease. The vaccine could surface a silent herpes virus infection, which would induce the erythema multiforme instead.

Sections du résumé

BACKGROUND
The 2019 Coronavirus disease (Covid-19) has affected thousands of people worldwide. To date, vaccines appear to be the only method to prevent and reduce mortality. Four vaccinations have been outwardly approved by European Medicine Agency (EMA) in Europe: BNT162b2 (Comirnaty-BioNTech/Pfizer), mRNA-1273 (Spikevax-Moderna), ChAdOx1 (VaxzevriaAstrazeneca), and Ad26.COV2-S (Janssen-Johnson&Johnson). After vaccination, local and systemic adverse effects can occur. Cutaneous reactions like urticaria, local injection site pain, morbilliform rash have been documented after vaccination.
CASES PRESENTATION
We report four cases of oral erythema multiforme flare arising after BNT162b2 vaccination administration. All the patients denied previous erythema-like and herpetic manifestations history. Two of the reported cases (number 1 and 2) presented with both oral and cutaneous lesions, while cases 3 and 4 showed only oral manifestations. Three of the cases presented the erythema after the first vaccination dosage administration, only one case reported lesions after the second vaccination dosage administration. All the cases were treated with prednisone via oral administration and topical 0.05% clobetasol ointment.
CONCLUSIONS
The present reports represent some of the few cases of erythema multiforme occurring as a side effect of the BNT162b2 COVID-19 vaccination. The causal role of the vaccine for the erythema multiforme has not been proven yet; nevertheless, it is not uncommon for medications to trigger this disease. The vaccine could surface a silent herpes virus infection, which would induce the erythema multiforme instead.

Identifiants

pubmed: 35331228
doi: 10.1186/s12903-022-02124-2
pii: 10.1186/s12903-022-02124-2
pmc: PMC8943505
doi:

Substances chimiques

COVID-19 Vaccines 0
BNT162 Vaccine N38TVC63NU

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

90

Informations de copyright

© 2022. The Author(s).

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Auteurs

Massimo Petruzzi (M)

Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy.
Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland.

Sara Galleggiante (S)

Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy.

Sabrina Messina (S)

Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy.

Fedora Della Vella (F)

Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy. dellavellaf@gmail.com.

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Classifications MeSH