Tchernev Georgi, Kordeva Simona, Kirilova Heily, Broshtilova Valentina
Onkoderma - Clinic for Dermatology, Venereology and Dermatologic Surgery, Sofia.
Department of Dermatology and Venereology, Medical Institute of Ministry of Interior, Sofia.
Dermatol Reports. 2023 Mar 1;15(2):9636. doi: 10.4081/dr.2023.9636. eCollection 2023 Jun 7.
Post-vaccinal and parainfectious activation of the immunity with subsequent development of a certain immunological/skinimmunological disease is not rare in clinical practice. This concept is mentioned in relation to molecular/antigenic mimicry. To this day, the pathogenesis of sarcoidosis and sarcoid-type reactions remains a mystery. Moreover, they can be a warning sign of changes in tissue homeostasis, whether they are infectious, noninfectious- immunological, tumor-related, . We present a rare form of erythrodermic sarcoidosis with massive systemic involvement (pericarditis, supraventricular tachycardia, hepatitis, iritis/iridocyclitis, pulmonary fibrosis/bihilar lymphadenopathy, and arthritis) developed after receiving the ChadOx1-S vaccine for COVID- 19. Systemic immunosuppressive therapy with Methylprednisolone was introduced according to a scheme (in a reduction mode with an initial dose of 40 mg/day intravenously) in combination with topical Pimecrolimus 1% cream twice a day. Rapid improvement of the symptoms was observed within the first two days of treatment. According to the scientific literature, the presented patient turns out to be the first case of erythrodermic sarcoidosis (with systemic involvement), described as a side effect after vaccination and/or administration of a certain medicinal form.
接种疫苗后及感染后免疫激活，随后发展为某种免疫性/皮肤免疫性疾病，在临床实践中并不罕见。这一概念与分子/抗原模拟有关。时至今日，结节病和结节样反应的发病机制仍是个谜。此外，无论它们是感染性、非感染性免疫性、肿瘤相关性的，它们都可能是组织稳态变化的警示信号。我们报告了1例罕见的红皮病型结节病，在接种ChadOx1-S新冠疫苗后出现广泛的全身受累（心包炎、室上性心动过速、肝炎、虹膜炎/虹膜睫状体炎、肺纤维化/双侧肺门淋巴结肿大和关节炎）。根据治疗方案（以递减模式，初始剂量为静脉注射40mg/天）采用甲泼尼龙进行全身免疫抑制治疗，并联合每天两次外用1%吡美莫司乳膏。在治疗的前两天内观察到症状迅速改善。根据科学文献，该患者是首例被描述为接种疫苗和/或服用某种药物剂型后的副作用的红皮病型结节病（伴有全身受累）病例。
