Grieco Teresa, Ambrosio Luca, Trovato Federica, Vitiello Martina, Demofonte Ilaria, Fanto Marta, Paolino Giovanni, Pellacani Giovanni
Dermatology Unit, Sapienza University of Rome, 00185 Rome, Italy.
Unità di Dermatologia, Ospedale San Raffaele, 20121 Milano, Italy.
J Clin Med. 2022 Mar 25;11(7):1822. doi: 10.3390/jcm11071822.
Patients affected by pre-existing chronic spontaneous/Inducible urticaria (CSU/CIU) still feel unsafe due to the potential risk of an Adverse Event Following Immunization (AEFI) and Cutaneous Adverse Reactions (CARs) of COVID-19 vaccines. The appropriate management in this field remains debated and evidence is still lacking.
We considered 160 CSU/CIU patients in Omalizumab/antihistamine therapy who received two doses of Comirnaty/Moderna mRNA vaccines; 20 of them also received a booster dose. Urticaria Activity Score-7 (UAS7) was used to assess the severity of the disease. Demographics, medical history, AEFI and CARs outcome after vaccination were collected by administering a web-based questionnaire completed by phone interview.
In total, 147 patients did not show urticaria relapse (91.88%). Worsening cutaneous symptoms were experienced by 13 of our patients (8.12%). Exacerbation had a mean duration of 2 days and 11 h and mostly occurred after the first dose (69.23%). Systemic mild side effects were experienced by 9 patients (5.62%). No severe reactions were observed.
Omalizumab can potentially prevent CARs and AEFI; however, major problems were registered during the 2-month stop period scheduled in the treatment. We suggest patients should not undergo vaccination during this period. CSU/CIU exacerbations appear to be transient and can be managed by antihistamines.
由于存在接种新冠疫苗后发生免疫接种不良事件（AEFI）和皮肤不良反应（CARs）的潜在风险，患有既往慢性自发性/诱发性荨麻疹（CSU/CIU）的患者仍然感到不安全。该领域的适当管理仍存在争议，且证据仍然不足。
我们纳入了160例接受奥马珠单抗/抗组胺药治疗且接种了两剂辉瑞/BioNTech mRNA疫苗或莫德纳mRNA疫苗的CSU/CIU患者；其中20例还接受了加强剂量。采用荨麻疹活动评分-7（UAS7）评估疾病严重程度。通过电话访谈完成一份基于网络的问卷，收集患者的人口统计学信息、病史、接种疫苗后的AEFI和CARs结果。
总共147例患者未出现荨麻疹复发（91.88%）。13例患者（8.12%）出现了皮肤症状加重。症状加重的平均持续时间为2天11小时，且大多发生在第一剂接种后（69.23%）。9例患者（5.62%）出现了全身性轻度副作用。未观察到严重反应。
奥马珠单抗可能预防CARs和AEFI；然而，在治疗计划的2个月停药期出现了主要问题。我们建议患者在此期间不应接种疫苗。CSU/CIU加重似乎是短暂的，可用抗组胺药进行处理。
