A case of cutaneous small vessel vasculitis after the seventh dose of COVID-19 vaccination.

A 77-year-old woman on regular hemodialysis was admitted due to purpura on her extremities, elevated C-reactive protein (CRP), D-dimer, and syncope attack. Despite hospitalization and treatment, her purpura got worse, and a skin biopsy revealed cutaneous small vessel vasculitis (CSVV). No apparent cause could be pointed out for CSVV. Her purpura had deteriorated until we started treatment with prednisolone (PSL). We later confirmed that she had received her seventh COVID-19 vaccination before the onset of purpura on her extremities. In this case, the highlight is that even the seventh dose of the COVID-19 vaccination could potentially induce CSVV.