Cutaneous Adverse Reactions Associated with COVID-19 Vaccines

1. Abstract

1.1. Background: SARS-CoV-2 vaccination is crucial to reduce the risk of hospitalization, injury and mortality. However, several adverse cutaneous reactions can occur.

1.2. Objectives: Objective was to collect and classify cutaneous side effects after SARS-CoV-2 vaccination in a Moroccan case series.

1.3. Methods: A cross-sectional observational study among patients referred to the Dermatology Department of Ibn Rochd Hospital from February 2021 to November 2021. Patients of all ages vaccinated against COVID-19 who developed a skin manifestation within 1 month of administration of vaccine that had been approved by the national technical and scientific committee in Morocco (Sinopharm and Astrazeneca then Pfizer-BioNTech). Patients with explainable causes other than SARS-CoV-2 vaccination were excluded.

1.4. Results: A total of 47 patients were identified with cutaneous reactions after COVID-19 vaccination: AstraZeneca (53,19 %), Sinopharm (38,29 %), and mRNAPfizer-BioNTech vaccine (8,51 %). Allergic-type reactions (46.80%): urticaria (10.63%), urticaria with angioedema (10.63%), pruritus (10.63%), morbilliform eruption (4.25%), Quincke's edema (2.12%), DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome (2.12%), Stevens-Johnson syndrome (2.12%), lichenoid drug eruption (2.12%), anaphylactic reaction (2.12%). Inflammatory skin reactions (17.02%): Erythema nodosum (8.51%), psoriasis (4.25%), lupus (2.12%), Shulman fasciitis (2.12%). Autoimmune reactions (14.89%): bullous pemphigoid (6.38%), pemphigus vulgaris (2,12%), urticarial vasculitis (4.25%) and vitiligo (2.12%). Viral reactivation: zoster reactivations (8.51%), herpetic reactivations (4.25%). Reactions described after infection with COVID-19: erythema multiforme (4.25%), Varicella-like rash (2.12%). In addition, a generalized annular rash was noted in a single patient (2.12%).

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