Mansoura Dermatology, Venerology and Leprology Hospital, Mansoura, Egypt.
Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy.
Dermatol Ther. 2022 Jun;35(6):e15458. doi: 10.1111/dth.15458. Epub 2022 Mar 25.
Currently the most powerful tool in combating the COVID-19 pandemic is vaccination against SARS-CoV-2. A growing percentage of the world's population is being vaccinated. Various vaccines are worldwide on the market. Several adverse reactions have been reported as a part of post-marketing surveillance of COVID-19 vaccines. Among the possible adverse events, cutaneous vasculitis has occasionally been reported. We present a narrative review on cutaneous vasculitis related to COVID-19-vaccination to summarize clinical findings, histopathology, treatment and outcome. We searched for "COVID vaccine", "COVID vaccination" AND "cutaneous vasculitis" in PUBMED. Articles in English have been selected, from inception to December 2021, and analyzed for patient's characteristics, type of vaccine, time of appearance of cutaneous vasculitis and clinico-histopathologic type. Treatment and outcome have also been considered in this narrative review. Two new unpublished cases of ours were added. Cutaneous vasculitis is a rare adverse event to COVID-19 vaccination. It has been observed with mRNA and adenovirus-vector vaccines. IgA vasculitis, lymphocytic and ANCA-associated vasculitis, leukocytoclastic and urticarial vasculitis have been reported. This adverse event can occur after first or second shot. Most cases run a mild to moderate course. Cornerstone of medical treatment are systemic corticosteroids. Complete remission could be achieved in most patients. Vasculitis may not be considered as a contraindication of vaccination, being uncommonly reported and shows a favorable prognosis. The benefit of the vaccination remains high especially for immunocompromised patients. COVID-vaccine induced vasculitis is important in the differential diagnosis of purpuric and vasculitis disorders.
目前，抗击 COVID-19 大流行最有力的工具是针对 SARS-CoV-2 的疫苗接种。越来越多的世界人口正在接种疫苗。世界各地有多种疫苗上市。在 COVID-19 疫苗的上市后监测中，已经报告了一些不良反应。在可能的不良事件中，偶尔会报告皮肤血管炎。我们对与 COVID-19 疫苗接种相关的皮肤血管炎进行了叙述性综述，以总结临床发现、组织病理学、治疗和结局。我们在 PUBMED 中搜索了“COVID 疫苗”、“COVID 接种”和“皮肤血管炎”。选择了从开始到 2021 年 12 月的英文文章，并分析了患者特征、疫苗类型、皮肤血管炎出现时间和临床病理类型。在本叙述性综述中还考虑了治疗和结局。我们增加了两个新的未发表的病例。皮肤血管炎是 COVID-19 疫苗接种的罕见不良反应。已在 mRNA 和腺病毒载体疫苗中观察到。已报道 IgA 血管炎、淋巴细胞性和 ANCA 相关血管炎、白细胞碎裂性和荨麻疹性血管炎。这种不良反应可能发生在第一针或第二针之后。大多数病例病程为轻度至中度。医学治疗的基石是全身性皮质类固醇。大多数患者可达到完全缓解。血管炎不应被视为疫苗接种的禁忌症，因为它很少被报道，且预后良好。疫苗接种的益处仍然很高，尤其是对免疫功能低下的患者。COVID-19 疫苗诱导的血管炎在鉴别紫癜性和血管炎性疾病方面很重要。
