Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
J Dermatol. 2023 Sep;50(9):1190-1193. doi: 10.1111/1346-8138.16808. Epub 2023 Apr 26.
Generalized bullous fixed drug eruption (GBFDE) is a rare type of life-threatening severe cutaneous adverse reaction that is considered a medical emergency because of its potential lethality. Currently, only a few cases of bullous adverse reactions have been reported after coronavirus disease 2019 (COVID-19) vaccination. We describe a patient with distinct clinical, histopathological, and immunological findings that are consistent with severe GBFDE, after Pfizer messenger RNA COVID-19 vaccination. An 83-year-old man presented with a fever and well-demarcated multiple erythematous patches that occurred only 4 h after receiving the first dose of COVID-19 Pfizer vaccination. Over the next few days, the patches became generalized and turned into blisters covering approximately 30% of the body surface. The patient was started on intravenous methylprednisolone and oral cyclosporine. There were no additional blistering lesions after 10 days of treatment, prompting a gradual dose reduction. Our case suggests that a stepwise vaccination adhering to the standard dosing schedule should be warranted with close monitoring for possible significant side effects.
泛发性大疱固定型药物疹（GBFDE）是一种罕见的危及生命的严重皮肤不良反应，因其潜在的致命性，被视为医疗急救事件。目前，仅有少数 COVID-19 疫苗接种后出现大疱不良反应的病例报告。我们描述了一例接种辉瑞信使 RNA COVID-19 疫苗后，具有明显临床、组织病理学和免疫学表现，符合严重 GBFDE 的患者。一名 83 岁男性在接种 COVID-19 辉瑞疫苗第一剂后 4 小时出现发热和界限清楚的多个红斑性斑块，且仅发生在这些斑块处。几天后，斑块泛发并形成水疱，累及约 30%的体表面积。患者开始接受静脉注射甲基强的松龙和口服环孢素治疗。治疗 10 天后，未出现新的水疱性皮损，遂逐渐减少剂量。我们的病例提示，应按照标准剂量方案逐步接种疫苗，并密切监测可能出现的严重不良反应。
