Research Assistant Iran University of Medical Sciences, Tehran, Iran.
Research Assistant Division of Dermatology, Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada.
Am J Dermatopathol. 2023 Jan 1;45(1):1-27. doi: 10.1097/DAD.0000000000002320. Epub 2022 Nov 7.
Coronavirus 2 is an infectious agent primarily identified as the cause of a pandemic viral pneumonia. With the mass vaccination against this virus, one of the health issues is the safety of currently available vaccines considering their adverse reactions. This systematic review was conducted to assess and summarize all reported data on histopathologic findings associated with mucocutaneous reactions that developed after COVID-19 vaccination for a better pathophysiology interpretation and clinical management of these reactions. A systematic search was performed in PubMed, Web of Science, and Scopus databases as well as Google Scholar engine for relevant English articles published till July 1, 2022. This review includes 131 studies with a total number of 287 cases. Eruptions that underwent a biopsy were mostly described as erythematous maculopapular, papulosquamous, vasculitis-like, lichenoid, or urticarial lesions. Histopathology revealed spongiosis, interstitial, and perivascular lymphohistiocytic infiltration, erythrocyte extravasation, parakeratosis, endothelial inflammation, and the like. Findings were highly consistent with morbilliform erythema, psoriasiform dermatosis, leukocytoclastic vasculitis, and lichenoid or urticarial drug reactions. The majority of these reactions had a mild nature and were primarily observed in patients with underlying health conditions. Microscopic evaluation was also consistent with transient inflammatory changes, and features like neutrophilic infiltrates, subcorneal pustules, and vasculopathy were less frequently reported than what seen in COVID infection. Therefore, dermatologic reactions developing after vaccination in the general population should not hinder a complete vaccination.
冠状病毒 2 是一种传染性病原体，主要被确定为导致大流行病毒性肺炎的原因。随着针对这种病毒的大规模疫苗接种，其中一个健康问题是考虑到目前可用疫苗的不良反应，评估和总结与 COVID-19 疫苗接种后发生的粘膜皮肤反应相关的组织病理学发现的所有报告数据的安全性。在 PubMed、Web of Science 和 Scopus 数据库以及 Google Scholar 引擎中进行了系统检索，以查找截至 2022 年 7 月 1 日发表的相关英文文章。本综述包括 131 项研究，共 287 例病例。接受活检的皮疹大多描述为红斑性斑丘疹、丘疹鳞屑性、血管炎样、苔藓样或荨麻疹样病变。组织病理学显示海绵状水肿、间质和血管周围淋巴组织细胞浸润、红细胞外渗、角化不全、内皮炎症等。这些发现与麻疹样红斑、银屑病样皮肤病、白细胞碎裂性血管炎和苔藓样或荨麻疹样药物反应高度一致。大多数这些反应的性质较轻，主要发生在有基础健康状况的患者中。显微镜评估也与短暂的炎症变化一致，与 COVID 感染相比，中性粒细胞浸润、表皮下脓疱和血管病变等特征的报道较少。因此，普通人群接种疫苗后出现的皮肤反应不应妨碍完全接种疫苗。
