Clinical and pathologic correlation of cutaneous COVID-19 vaccine reactions including V-REPP: A registry-based study - 09/12/21
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Abstract |
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.
Le texte complet de cet article est disponible en PDF.Key words : Ad26.COV2.S, AZD1222, BNT162b2, bullous pemphigoid, chilblains, COVID-19, delayed large local, dermal hypersensitivity reaction, dermatology, dermatopathology, erythema multiforme, erythromelalgia, Johnson & Johnson Janssen, lichen planus, Moderna, morbilliform, mRNA-1273, Oxford-AstraZeneca, papular, papulosquamous, pathology, pernio, Pfizer-BioNTech, pityriasis rosea, psoriasis, registry, SARS-CoV-2, Stevens-Johnson syndrome, urticaria, vaccine, zoster
Abbreviations used : IQR, V-REPP
Plan
| Funding sources: The COVID-19 dermatology registry is supported by a grant from the International League of Dermatological Societies and by in-kind support from the American Academy of Dermatology. |
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| IRB approval status: The registry was reviewed by the Partners Healthcare (Massachusetts General Hospital) Institutional Review Board and it was determined that it did not meet the definition of human subjects research. |
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| Reprints not available from the authors. |
Vol 86 - N° 1
P. 113-121 - janvier 2022 Retour au numéro
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