Author
Qisi Sun
Bio: Qisi Sun is an academic researcher from Yale University. The author has contributed to research in topics: Health care. The author has an hindex of 2, co-authored 2 publications receiving 14 citations.
Topics: Health care
Papers
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TL;DR: The authors reviewed the dermatologic manifestations of COVID-19 vaccines as reported in clinical trial data and summarized additional observational reports of skin reactions to COVID19 vaccines, concluding that early-onset local injection reactions were the most common cutaneous side effects observed in clinical trials, while delayed injection reactions reported outside of clinical trials.
75 citations
TL;DR: In this article, dermatologists from 11 countries share insights gained from local experience to provide a better framework for delivering quality dermatologic care and understanding how the field has evolved during this medical crisis.
6 citations
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TL;DR: There is growing evidence that not only the novel coronavirus disease (COVID-19) but also the COVID19 vaccines can cause a variety of skin reactions as mentioned in this paper, including delayed large local skin lesions, inflammatory reactions in dermal filler or previous radiation sites or even old BCG scars.
Abstract: There is growing evidence that not only the novel coronavirus disease (COVID-19) but also the COVID-19 vaccines can cause a variety of skin reactions. In this review article, we provide a brief overview on cutaneous findings that have been observed since the emerging mass COVID-19 vaccination campaigns all over the world. Unspecific injection site reactions very early occurring after the vaccination are most frequent. Type I hypersensitivity reactions (e.g., urticaria, angioedema, anaphylaxis) likely due to allergy to ingredients may rarely occur but can be severe. Type IV hypersensitivity reactions may be observed, including delayed large local skin lesions ("COVID arm"), inflammatory reactions in dermal filler or previous radiation sites or even old BCG scars, and more commonly moribilliform and erythema multiforme-like rashes. Autoimmune-mediated skin findings after COVID-19 vaccination include leukocytoclastic vasculitis, lupus erythematosus, and immune thrombocytopenia. Functional angiopathies (chilblain-like lesions, erythromelalgia) may also be observed. Pityriasis rosea-like rashes and reactivation of herpes zoster have also been reported after COVID-19 vaccination. In conclusion, there are numerous cutaneous reaction patterns that may occur following COVID-19 vaccination, whereby many of these skin findings are of immunological/autoimmunological nature. Importantly, molecular mimicry exists between SARS-CoV-2 (e.g., the spike-protein sequences used to design the vaccines) and human components and may thus explain some COVID-19 pathologies as well adverse skin reactions to COVID-19 vaccinations.
114 citations
TL;DR: 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 papule with fine scale as discussed by the authors .
Abstract: Cutaneous reactions after COVID-19 vaccination have been commonly reported; however, histopathologic features and clinical correlations have not been well characterized.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.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).Cases in which histopathology was available represented a minority of registry entries. Analysis of registry data cannot measure incidence.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.
92 citations
Harvard University1, Massachusetts General Hospital2, University of Pennsylvania3, Yale University4, University of Texas Southwestern Medical Center5, Henry Ford Health System6, Medical University of South Carolina7, Saint Louis University8, Ludwig Maximilian University of Munich9, University of Miami10, University of California, San Francisco11
TL;DR: In this article, the authors defined a subset of vaccine-related eruption of papules and plaques, as well as 12 other patterns, following COVID-19 vaccination and classified them by reaction patterns.
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.
92 citations
TL;DR: In this paper, the authors performed a literature research concerning cutaneous adverse drug reactions (ADRs) to different COVID-19 vaccines, and incorporated their own experiences, finding that injection site reactions are the most frequent side effects arising from all vaccine types.
55 citations
TL;DR: Based on the findings, mucocutaneous adverse events were mostly non‐significant, self‐limiting reactions, and for the more uncommon moderate to severe reactions, guidelines and consensus position papers could be of great importance to provide those at higher risks and those with specific worries of flare‐ups or inefficient immunization with sufficient recommendations to safely schedule their vaccine doses, or avoid vaccination if they have the discussed contra‐indications.
Abstract: With dermatologic side effects being fairly prevalent following vaccination against COVID‐19, and the multitude of studies aiming to report and analyze these adverse events, the need for an extensive investigation on previous studies seemed urgent, in order to provide a thorough body of information about these post‐COVID‐19 immunization mucocutaneous reactions. To achieve this goal, a comprehensive electronic search was performed through the international databases including Medline (PubMed), Scopus, Cochrane, Web of science, and Google scholar on July 12, 2021, and all articles regarding mucocutaneous manifestations and considerations after COVID‐19 vaccine administration were retrieved using the following keywords: COVID‐19 vaccine, dermatology considerations and mucocutaneous manifestations. A total of 917 records were retrieved and a final number of 180 articles were included in data extraction. Mild, moderate, severe and potentially life‐threatening adverse events have been reported following immunization with COVID vaccines, through case reports, case series, observational studies, randomized clinical trials, and further recommendations and consensus position papers regarding vaccination. In this systematic review, we categorized these results in detail into five elaborate tables, making what we believe to be an extensively informative, unprecedented set of data on this topic. Based on our findings, in the viewpoint of the pros and cons of vaccination, mucocutaneous adverse events were mostly non‐significant, self‐limiting reactions, and for the more uncommon moderate to severe reactions, guidelines and consensus position papers could be of great importance to provide those at higher risks and those with specific worries of flare‐ups or inefficient immunization, with sufficient recommendations to safely schedule their vaccine doses, or avoid vaccination if they have the discussed contra‐indications.
27 citations