COVID-19 Vaccine-Induced Lichenoid Drug Eruption
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Abstract
The global rollout of COVID-19 vaccines has been a significant step in controlling the SARS-CoV-2 pandemic. While the vaccines have proven to be generally safe, adverse reactions, including both local and systemic effects, have been observed. Cutaneous manifestations, though rare, have been reported in some instances.
We report the case of a 67-year-old male who developed pruritic erythematous-to-violaceous papules and plaques three days after receiving the second dose of a COVID-19 vaccine. The lesions were found on the right inner thigh, forearms, trunk, and neck. Histopathological examination revealed findings consistent with a lichenoid drug eruption (LDE), a condition typically linked to medications or, in rarer cases, vaccines.
Lichenoid drug eruptions are often seen in association with certain medications, and less commonly with Hepatitis B vaccination. However, this case presents an uncommon presentation of LDE following COVID-19 vaccination, with an atypical distribution of lesions, involvement of uncommon sites, and no history of prior drug or vaccine hypersensitivity.
This case underscores the importance of recognizing rare or atypical skin manifestations, such as lichenoid drug eruptions, as potential vaccine-related adverse effects. Identifying these conditions allows clinicians to ensure accurate diagnosis and appropriate management.
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References
I. Meo SA, Bukhari IA, Akram J, et al. COVID-19 vaccines: Comparison of biological, pharmacological characteristics and adverse effects of Pfizer/BioNTech and Moderna Vaccines. Eur Rev Med Pharmacol Sci. 2021 Feb;25(3):1663-1669.
II. Folegatti PM, Ewer KJ, Aley PK, et al. Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial. Lancet. 2020 Aug 15;396(10249):467-478.
III. Yuan l, Yuan P, Ai P, Liu Y, et al. Safety, Tolerability, and Immunogenicity of COVID-19 Vaccines: A Systematic Review and Meta-Analysis. Preprint. medRxiv. 2020 Nov
;2020.11.03.20224998.
IV. Alghamdi M, Alsanad S, Alrashed A, et al. Cutaneous reactions following COVID-19 vaccinations: A review. J Dermatol.
;50(3):234-24.
V. Patel N, Kumari N, Vashisht S, et al. Vaccine-induced cutaneous reactions: A comprehensive review. J Clin Aesthet Dermatol. 2022;15(10):45-52.
VI. AstraZeneca. COVID-19 vaccine AstraZeneca analysis print. April 2021.
VII. Aze Santiago-Morales E, Campos-Batista R, Ibarra-Pérez C, et al. Lichenoid drug eruption and hepatitis B vaccination. Dermatol Ther. 2021;34(8):e15013.
VIII. Sharma P, Agarwal M, Sethi S. Lichenoid drug eruption vs idiopathic lichen planus: An overlap syndrome? Clin Dermatol Rev. 2020;24(2):121-127.
IX. Pappas R, Johnson H, Wang L, et al. COVID-19 vaccine and rare cutaneous reactions: Case studies and literature review. J Am Acad Dermatol. 2024;87(1):21-28.