Clinical and pathologic correlation of cutaneous COVID-19 vaccine reactions including V-REPP: A registry-based study

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:86

Article

McMahon, Devon E.¹  Kovarik, Carrie L.²  Damsky, William³  Rosenbach, Misha²  Lipoff, Jules B.²  Tyagi, Anisha⁴  Chamberlin, Grace⁴  Fathy, Ramie²  Nazarian, Rosalynn M.⁵  Desai, Seemal R.^6,7  Lim, Henry W.⁸  Thiers, Bruce H.⁹  Hruza, George J.¹⁰  French, Lars E.^11,12  Blumenthal, Kimberly¹³  Fox, Lindy P.¹⁴  Freeman, Esther E.^1,4 

[1] Harvard Med Sch, Massachusetts Gen Hosp, Dept Dermatol, Boston, MA 02115 USA

[2] Univ Penn, Dept Dermatol, Philadelphia, PA 19104 USA

[3] Yale New Haven Hosp, Dept Dermatol, 20 York St, New Haven, CT 06504 USA

[4] Massachusetts Gen Hosp, Mongan Inst, Med Practice Evaluat Ctr, Boston, MA 02114 USA

[5] Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02114 USA

[6] Univ Texas Southwestern Med Ctr Dallas, Dept Dermatol, Dallas, TX USA

[7] Innovat Dermatol, Plano, TX USA

[8] Henry Ford Hlth Syst, Dept Dermatol, Detroit, MI USA

[9] Med Univ South Carolina, Dept Dermatol & Dermatol Surg, Charleston, SC 29425 USA

[10] St Louis Univ, Dept Dermatol, St Louis, MO 63103 USA

[11] Munich Univ Ludwig Maximilian, Univ Hosp, Dept Dermatol, Munich, Germany

[12] Univ Miami, Miller Sch Med, Dr Phillip Frost Dept Dermatol & Cutaneous Surg, Miami, FL 33136 USA

[13] Massachusetts Gen Hosp, Dept Med, Div Rheumatol Allergy Immunol, Boston, MA 02114 USA

[14] Univ Calif San Francisco, Dept Dermatol, San Francisco, CA USA

关键词: 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;   

DOI  :  10.1016/j.jaad.2021.09.002

来源: Elsevier

【 摘 要 】

Background: Cutaneous reactions after COV1D-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.

【 授权许可】

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