Cutaneous reactions post-COVID-19 vaccination. Case series and literature review

Abstract

Background: In Saudi Arabia, three approved vaccines against severe acute respiratory syndrome coronavirus 2 (AstraZeneca [AZD1222], Pfizer-BioNTech [BNT162b2] and [Ad26. COV 2-S] Moderna vaccine) have been administered to the population. Objective: To characterise cutaneous adverse events associated with COVID-19 vaccines. Methodology: We collected information on 26 patients presented to two secondary health care facilities, over the period extending from mid of December 2020 to the 1st of January 2022 with cutaneous reactions after COVID-19 vaccine administration. Data were descriptively analysed using Statistical Package for the Social Sciences, SPSS 23rd version. Results: A total of 53.8% of the patients were male; 31% of the patients reported having at least one chronic illness. Reactions were most frequent after the first dose (57.6% of the patients). Messenger RNA-based vaccines were the most frequently noted vaccines associated with the reactions (76.9% of the cases). The most common reactions were cutaneous small-vessel vasculitis (19.2%), interface/lichenoid reactions (19.2%), psoriasis (15.4%), and acute urticaria (11.5%). Only 11.5% patients required admission to the hospital for their clinical presentation. Conclusion: Most of our patients had mild reactions and were successfully managed with supportive treatments. However, still some patients may experience severe or long-lasting reactions requiring systemic therapies.