Shah Hemali, Busquets Ana C
College of Medicine, Albany Medical College, Albany, USA.
Dermatology, Weirton Medical Center, Weirton, USA.
Cureus. 2022 Jun 16;14(6):e25987. doi: 10.7759/cureus.25987. eCollection 2022 Jun.
Much of the literature involving COVID-19 and chronic inflammatory dermatological conditions have focused on the safety of immunomodulatory therapy in the setting of this highly infectious virus. While general mortality associated with the infection and vaccine has been studied in depth, the effects of the virus and vaccine on inflammatory skin disease states have not been. It is well known that psoriasis can be triggered by stress, infection, certain medications, and, although not as common, vaccinations. Further, existing literature has briefly commented on psoriasis flares after COVID vaccination, but these have not touched on flares among their patients' current therapy, nor flares after COVID infection. In this case report, we report five cases observed at our institution over the last year of either new-onset psoriasis or flares of previously well-controlled psoriasis shortly after infection with COVID-19 or COVID-19 vaccination, with no other identifiable triggers. These cases can serve to raise awareness of issues related to managing stubborn psoriatic flares and bring to the forefront conversations that are likely to arise with our patients regarding the risks and benefits of COVID vaccination and boosters. While the definitive etiology of the association between COVID and psoriasis remains unclear, it is important that the dermatologic community be aware when evaluating patients with new-onset or worsening psoriasis as we move forward in times of this COVID-19 era.
许多涉及新冠病毒（COVID-19）和慢性炎症性皮肤病的文献都聚焦于在这种高传染性病毒背景下免疫调节疗法的安全性。虽然已经深入研究了与感染和疫苗相关的总体死亡率，但病毒和疫苗对炎症性皮肤病状态的影响尚未得到研究。众所周知，银屑病可由压力、感染、某些药物引发，而且虽然不太常见，但疫苗接种也可引发。此外，现有文献简要提及了新冠疫苗接种后银屑病发作的情况，但这些文献既未涉及患者当前治疗期间的发作情况，也未涉及新冠病毒感染后的发作情况。在本病例报告中，我们报告了去年在我们机构观察到的5例病例，这些病例均在感染新冠病毒或接种新冠疫苗后不久出现新发银屑病或既往病情得到良好控制的银屑病发作，且无其他可识别诱因。这些病例有助于提高对处理顽固银屑病发作相关问题的认识，并将与患者就新冠疫苗接种和加强针的风险与益处可能展开的对话推到前沿。虽然新冠病毒与银屑病之间关联的确切病因仍不清楚，但在这个新冠疫情时代，皮肤科医生在评估新发或病情恶化的银屑病患者时保持警惕很重要。
