Authors Elina Khattab 1 , Eirini Christaki 2 , Constantinos Pitsios 1 Affiliations 1 Medical School, University of Cyprus, Nicosia, Cyprus. The https:// ensures that you are connecting to the (2020) 83:e5760. Bethesda, MD 20894, Web Policies One case of pityriasis rosea is reported in a patient infected with COVID19, and the most commonly reported features are exanthomatous rash, urticaria, chickenpox like vesicles, petechiae, and acute hemorrhagic edema of infancy. Urbina F, Das A, Sudy E. Clinical variants of pityriasis rosea. Pityriasis rosea, COVID-19 and vaccination: new keys to understand an old acquaintance. 2022 Mar 15;10(3):624. doi: 10.3390/microorganisms10030624. doi: 10.1016/j.jaad.2021.03.092, 15. We present the case of a female patient in whom the diagnosis of pityriasis rosea led to the investigation and diagnosis of the SARS-CoV-2 infection. Careers. See this image and copyright information in PMC. Keywords: adverse effect, coronavirus, cutaneous eruptions, immunization, pityriasis rosea, SARS-CoV-2, vaccine, case report, Citation: Leerunyakul K, Pakornphadungsit K and Suchonwanit P (2021) Case Report: Pityriasis Rosea-Like Eruption Following COVID-19 Vaccination. Pityriasis rosea and pityriasis rosea-like eruptions after COVID-19 vaccines. The https:// ensures that you are connecting to the Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review. Bookshelf doi: 10.12998/wjcc.v5.i6.203, 6. 2021 Aug;185(2):e34. It could be pityriasis rosea here's how to treat it. Some rare cases can take up to three months. -, Polack FP, Thomas SJ, Kitchin N et al. Pityriasis rosea-like rash after messenger RNA COVID-19 vaccination: A case report and review of the literature. However, if it does, the symptoms may last for a longer period. They were found on hands and feet, showing up as red or purple spots caused by bleeding under the skin. Your healthcare provider can typically diagnose pityriasis rosea after a physical exam. Treatment was initiated with systemic corticosteroid therapy - hydrocortisone hemisuccinate 200 mg/day for 7 days, and loratadine 10 mg 2 times a day. Herald patch in the right hypochondrium followed by typical oval-shaped secondary plaques, Pityriasis rosea lesions on the upper extremities, MeSH (2021) 85:4655. At home, she underwent systemic treatment with antihistamines and topical medication with dermatocorticosteroids. Although the exact pathophysiologic mechanisms of PR after vaccination remain unclear, immune responses to COVID-19 vaccines and disruption of T-cell mediated control of latent infections were implicated (12, 1518). A woman. Bookshelf In approximately 50% of people with pityriasis rosea, the patches itch. See this image and copyright information in PMC. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Inverse pityriasis rosea secondary to COVID-19 vaccination. Clinical aspect of the lesions after 7days of treatment. World J Clin Cases. Moreover, almost all lesions faded with associated post-inflammatory hyperpigmentation (Figure 2B). Marzano AV, Cassano N, Genovese G, Moltrasio C, Vena GA. Cutaneous manifestations in patients with COVID19: a preliminary review of an emerging issue. Treatment with topical 0.1% triamcinolone acetonide twice daily showed partial response after seven days. Before It was found on younger COVID-19 patients suffering milder forms of the virus. Atzori L, Pinna AL, Ferreli C, Aste N. Pityriasis rosea-like adverse reaction: review of the literature and experience of an Italian drug-surveillance center. Though there's no single-known cause, it may be brought on by a drug interaction, or the reactivation of herpes simplex virus 6 or 7. This site needs JavaScript to work properly. An official website of the United States government. To the best of our knowledge, there have been no reports of PR-like eruptions following inoculation with Oxford/AstraZeneca ChAdOx1 nCoV-19 (AZD1222) vaccine. This site needs JavaScript to work properly. Unauthorized use of these marks is strictly prohibited. Studies show that some skin conditions may appear with COVID-19, including pityriasis rosea. The most commonly inoculated vaccines include those against smallpox, followed by tuberculosis, poliomyelitis, influenza, and human papillomavirus virus (12, 13). Similar to other viral outbreaks, people can experience flu-like symptoms like a fever, aches, or a runny nose when the herald patch shows up, Lam says, though I was lucky enough to skip that step. Bethesda, MD 20894, Web Policies Herzum A, Trave I, D'Agostino F, Burlando M, Cozzani E, Parodi A. Clin Exp Vaccine Res. National Library of Medicine JAAD Int. J Eur Acad Dermatol Venereol. The rash itself usually doesnt blister or bleed, but in many cases, the skin may peel. Dermatologic side effects of COVID-19 vaccines range from morbilliform rash and pernio to pityriasis rosea and erythema multiforme. doi: 10.1111/bjd.20143. In: Knoop KJ, Stack LB, Storrow AB, et al., eds. Among 171 laboratory-confirmed COVID-19 patients with cutaneous manifestations from the registry, the most commonly reported were morbilliform rash (22 percent), pernio-like acral lesions (18 percent), urticaria (16 percent), macular erythema (13 percent), vesicular eruption (11 percent), papulosquamous eruption (9.9 percent), and retiform Dermatol Ther. Epub 2021 Jul 21. 2021 Nov 2;17(11):4097-4098. doi: 10.1080/21645515.2021.1963173. doi: 10.1111/ijd.13061. J Am Acad Dermatol. Epub 2021 Aug 7. NCI CPTC Antibody Characterization Program, Ritchie H., Mathieu E., Rodes-Guirao L., et al. Br J Dermatol. Herein, we are reporting a unique. Blood tests to check for causes of a rash that arent related to pityriasis rosea. Had I started new medication? Ciccarese G, Parodi A, Drago F. SARS-CoV-2 as possible inducer of viral reactivations. Pityriasis means scaly, and rosea means pink, but the rashes may look red, gray, brown or purple. Common causes of drug-induced PR-like eruptions include angiotensin-converting enzyme inhibitors, non-steroidal anti-inflammatory drugs, and gold. Vote for your favorite beauty products now! PMC doi: 10.1111/dth.13650, 7. doi: 10.1111/jdv.17342. Epub 2021 Apr 7. National Library of Medicine 2021;185(2):e34. Due to the rising incidence of coronavirus disease 2019 (COVID-19) worldwide, mass vaccination has been the cornerstone in preventing viral spread and decreasing morbidity and mortality. Among patients who received inactivated vaccines, another case of PR-like eruption was reported four days after the first dose of CoronaVac (SinoVac) (1). Among patients who received COVID-19 vaccines, PR-like eruptions have been reported following the first (n = 1) or second dose (n = 2) of BNT162b2 mRNA-based vaccines (3, 4). 2021 Aug;35(8):e491-e493. COVID-19 vaccines reactions, type I hypersensitivity reactions (such as urticaria, angioedema, and anaphylaxis), . . JAAD Int. The patient developed papulovesicular lesions in the crease lines of the trunk and extremities, four days after inoculation with a recombinant coronavirus vaccine (Covishield, India). (c) Patient 2: Thin red to tan oval plaques with peripheral scale on the trunk and proximal thigh. Copyright 2021 the Author(s). In addition to a corticosteroid cream, New York City-based dermatologist Macrene Alexiades recommends keeping showers short and lukewarm, as "water, sweat, and soap reportedly irritate and inflame the lesions. Viruses, Variants, and Vaccines: How COVID-19 Has Changed the Way We Look at Skin. 8 PDF Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases D. McMahon, E. Amerson, +11 authors E. Freeman Medicine Pityriasis rosea after administration of Pfizer-BioNTech COVID-19 vaccine Pityriasis rosea (PR) is an acute papulosquamous cutaneous disorder that classically presents with a herald patch rapidly followed by a widespread rash along skin cleavage lines. These strains of the herpes virus arent related to the strains that cause cold sores or genital herpes. Int J Infect Dis. The site is secure. doi: 10.1111/jdv.12942, 13. PR is a common self-limited papulosquamous eruption typically presenting with a large solitary pink-colored patch or plaque (i.e., herald patch), followed by secondary eruptions of smaller erythematous patches or plaques with associated peripheral collarette scaling distributed along the cleavage lines of the trunk, forming a Christmas tree pattern (5). Dermatol Online J. The herald patch is the telltale sign that your rash could be PR, but there are other common (though not universal) symptoms as well. If you develop symptoms of pityriasis rosea while pregnant, contact your healthcare provider right away. A team of researchers . Despite this rare complication, our report highlights that the presence of PR-like eruption is not a contraindication for subsequent vaccinations. I put on some hydrocortisone and went to sleep, then woke up with another mark on my side, a couple inches below my armpit. Bookshelf These types cannot cause cold sores or genital herpes. . Unauthorized use of these marks is strictly prohibited. 8600 Rockville Pike It may appear on any part of your body, but it usually appears on the trunk (torso), arms and legs. Cazzato G, Ambrogio F, Pisani MC, Colagrande A, Arezzo F, Cascardi E, Dellino M, Macorano E, Trilli I, Parente P, Lettini T, Romita P, Marzullo A, Ingravallo G, Foti C. Vaccines (Basel). eCollection 2022. doi: 10.1016/j.jaad.2020.04.094, 8. Federal government websites often end in .gov or .mil. Pityriasis rosea is a rash that usually appears on the torso, upper arms, thighs or neck. Marcantonio-Santa Cruz OY, Vidal-Navarro A, Pesqu D, Gimnez-Arnau AM, Pujol RM, Martin-Ezquerra G. J Eur Acad Dermatol Venereol. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Pityriasis rosea (PR)-like eruption is a cutaneous complication associated with several medications and vaccinations. Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature. doi: 10.1002/ccr3.6096. To the best of our knowledge, there have been no reports of PR-like eruptions following inoculation with Oxford/AstraZeneca ChAdOx1 nCoV-19 (AZD1222) vaccine. Clinical findings of pityriasis rosealike, Clinical findings of pityriasis rosealike eruption in the patients. These findings were consistent with a diagnosis of PR-like eruption. You may develop a raised, discolored, circular or oval-shaped patch that ranges from 1 to 6 centimeters (cm). For instance, the rash sometimes appears only under the arms or on the flanks. KL drafted the original manuscript. In addition to COVID-19 vaccination, she was currently taking medications (i.e., levetiracetam and thyroxin) for glioblastoma, and the two drugs had been prescribed for approximately nine months. Our expert physicians and surgeons provide a full range of dermatologic, reconstructive and aesthetic treatments options at Cleveland Clinic. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination: A systematic review and meta-analysis. Int J Infect Dis. Epub 2021 Aug 26. Histopathological findings of pityriasis rosealike eruption in patient 1. J Invest Dermatol. However, pityriasis rosea can look similar to other skin conditions, including: If theres any doubt, your healthcare provider may perform the following tests: In most cases, pityriasis rosea goes away without any treatment in six to eight weeks. Pityriasis rosea-like eruption after Pfizer-BioNTech COVID-19 vaccination. COVID-19; HHV, human herpes virus; Moderna; PR; PR, pityriasis rosea; PR-LE; PR-LE, pityriasis rosea-like eruption; Pfizer; coronavirus; dermatology; mRNA vaccine; mRNA, messenger RNA; pityriasis rosea; pityriasis rosealike eruption; vaccine. Epub 2022 May 31. Pityriasis Rosea Following Pfizer-BioNTech Vaccination in an Adolescent Girl. It is likely that a new viral trigger of pityriasis rosea is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). I tell my patient to use a gentle non-soap cleanser." Pityriasis rosea. Drug-induced PR-like eruption accounts for 2% of all cutaneous adverse drug reactions (10). . Dtsch Arztebl Int. 2021 Dec;108(6):317-318. doi: 10.12788/cutis.0411. Advertising on our site helps support our mission. Rationale: Published by Wolters Kluwer Health, Inc. Human herpesvirus-6,7, and Epstein-Barr virus reactivation in pityriasis rosea during COVID-19. JAAD Int. However, there isnt enough research to determine that stress may cause pityriasis rosea. "There's some emerging data where there are certain skin rashes that seem to be more associated with the COVID vaccine, and pityriasis rosea is one them. Please enable it to take advantage of the complete set of features! Dermatol Ther. The .gov means its official. The https:// ensures that you are connecting to the 2022 Nov 6;15:2369-2382. doi: 10.2147/CCID.S388245. 2021 Dec;108(6):317-318. doi: 10.12788/cutis.0411. Drago F, Ciccarese G, Javor S, Parodi A. Vaccine-induced pityriasis rosea and pityriasis rosea-like eruptions: a review of the literature. Luckily, it's not contagious. sharing sensitive information, make sure youre on a federal See this image and copyright information in PMC. See your skin clear. In my experience, patients with darker skin are more likely to present with atypical forms of the disorder. The site is secure. Women are 50% more likely to develop pityriasis rosea. Disseminated erythematous-papulosquamous lesions, with right laterocervical herald patch (clinical aspect on admission). Washrawirul C, Triwatcharikorn J, Phannajit J, Ullman M, Susantitaphong P, Rerknimitr P. J Eur Acad Dermatol Venereol. The .gov means its official. Pityriasis rosea-like eruption revealing COVID-19. doi: 10.1007/s10103-019-02783-8, 16. 2021;35(9):e546e548. Pityriasis Rosea According to the Mayo Clinic, pityriasis rosea is a rash that usually begins as a large circular or oval spot on your chest, abdomen, or back. Br J Dermatol 2021. This site needs JavaScript to work properly. Vaccinations have been identified to rarely cause several cutaneous reactions. 2021 Aug;185(2):e34. Moreover, while dermoscopy may facilitate the diagnosis of PR, its utility for atypical PR or PR-like lesions is still limited. Federal government websites often end in .gov or .mil. The site is secure. Department of Dermatology, Graduate School of Medicine, Kyusyu University, Japan. It is usually seen in children, adolescents, and young adults. NCI CPTC Antibody Characterization Program. Em Rata Just Debuted a Chic Italian Bob With Baby Bangs. In a registry-based study, PR-like eruption was observed in only 12% of patients (14). We present two cases of COVID-19 vaccine-induced pityriasis rosea. Some patients may have a cold before the rash. Accessibility Authors Jordan E Buckley 1 , Laura N Landis 2 , Ronald P Rapini 1 Affiliations doi: 10.1002/jmv.26549, 9. "Any type of stress on the body can sometimes [cause them, and] any vaccine, not just the COVID one.". Pityriasis rosea (PR) is an acute papulosquamous cutaneous disorder that classically presents with a herald patch rapidly followed by a widespread rash along skin cleavage lines. PMC Unauthorized use of these marks is strictly prohibited. Clipboard, Search History, and several other advanced features are temporarily unavailable. Our reported case adds to the other findings regarding the association of PR with SARS-CoV-2 infection, in the context of the pandemic, suggesting the need to test patients with PR skin lesions for SARS-CoV-2 infection. MeSH Coronavirus pandemic (COVID-19), McMahon D.E., Amerson E., Rosenbach M., et al. (Unfortunately, I scratched my rash until it bled, so my hyperpigmentation may linger.). The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). In: Kelly A, Taylor SC, Lim HW, et al., eds. Accessibility Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Clin Cosmet Investig Dermatol. (a) Patient 1: Thin, Histopathological findings of pityriasis rosealike, Histopathological findings of pityriasis rosealike eruption in patient 1. These patches are smaller than the herald patch they range from 1 to 2 cm and are often called daughter patches. doi: 10.1111/jdv.17316, PubMed Abstract | CrossRef Full Text | Google Scholar, 2. Federal government websites often end in .gov or .mil. Cutaneous Eruptions in the Course of COVID-19 Among Geriatric Patients in a Nursing Home in Poland. Birlutiu V, Dobritoiu ES, Lupu CD, Herteliu C, Birlutiu RM, Dragomirescu D, Vorovenci A. Cleveland Clinic is a non-profit academic medical center. MeSH Careers. While unusual, one patient developed pityriasis rosea once a year for five years in a row. Pityriasis Rosea Shortly After mRNA-1273 COVID-19 Vaccination. Pityriasis rosea is a common condition that causes discolored patches on your skin. 2022 Mar 9;35(3):342-343. doi: 10.1080/08998280.2022.2044742. 6 Called a "herald patch,". PMC Please enable it to take advantage of the complete set of features! The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. eCollection 2022. | Pityriasis Rosea, COVID-19 and . Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature. Few brownish patches also appeared, suggestive of post-inflammatory hyperpigmentation. Careers. Some people see the rash disappear within 6 to 8 weeks, but it can take 5 months or longer for the skin to clear. Unable to load your collection due to an error, Unable to load your delegates due to an error. and transmitted securely. Cutis. PR also tends to occur in patients between the ages of 10 to 35 that are usually otherwise healthy, Lam says. 2021;35(8):e489e491. While my particular flare-up itched a lot, that's not always the case. government site. Epub 2021 Nov 2. Once its gone, you likely wont develop it again. The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of Cond Nast. (2019) 34:185764. Like previously reported cutaneous eruptions associated with COVID-19 infection, these cases "raise more questions than . However, adverse effects to COVID-19 vaccines, particularly cutaneous reactions, have been reported. Epub 2022 May 3. If you need help purchasing a product directly from Allure, go to our FAQ. Epub 2020 Nov 20. An official website of the United States government. HHS Vulnerability Disclosure, Help Disclaimer. An official website of the United States government. sharing sensitive information, make sure youre on a federal Epub 2022 Jun 26. . (b) haematoxylineosin, original magnification 20. FOIA 2022 Jun;7:164-168. doi: 10.1016/j.jdin.2022.01.009. (a) haematoxylineosin, original magnification 10. ", Though there's no single-known cause, King says, "pityriasis rosea is associated with reactivation of herpesviruses 6 and 7 [HHV-6 and HHV-7, respectively], which cause the primary rash, roseola, in infants. Pityriasis Rosea Associated With COVID-19 Vaccination: A Common Rash Following Administration of a Novel Vaccine. Dermatol Ther. doi: 10.1111/j.0022-202X.2005.23719.x. 2021 Nov;35(11):e721-e722. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. 2022 Nov 6;15:2369-2382. doi: 10.2147/CCID.S388245. Bethesda, MD 20894, Web Policies 2022 Aug;20(8):1123-1124. doi: 10.1111/ddg.14784. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). eCollection 2022. All rights reserved. 2022 Nov;36(11):1947-1968. doi: 10.1111/jdv.18294. Human herpesvirus-6, -7, and Epstein-Barr virus reactivation in pityriasis rosea during COVID-19. Pearls and pitfalls: Adverse cutaneous reactions after COVID-19 vaccination. Pityriasis rosea after administration of Pfizer-BioNTech COVID-19 vaccine. Federal government websites often end in .gov or .mil. National Library of Medicine Due to the temporal relationship between vaccination and onset of rash, COVID-19 vaccination was the most likely etiology. doi: 10.1111/jdv.17498. According to King, an in-person skin exam is usually enough to make an accurate diagnosis, though a biopsy or blood work may be necessary for some. KL and KP collated resources. Br J Dermatol. Pityriasis rosea (pih-tuh-RY-uh-sis ROH-zee-uh) is a common skin condition that causes patches of your skin to develop raised, scaly rashes. Pityriasis rosea developing after COVID-19 vaccination. Epub 2021 May 29. doi: 10.1111/jdv.17342, 5. I video-chatted with my dermatologist who asked a few questions: Did I have body aches or flu-like symptoms? Most of the rare, severe allergic reactions to these vaccines have occurred in people with a history of allergies. The Covid Symptom Study. We present two cases of COVID-19 vaccine-induced pityriasis rosea. With COVID-19 vaccines being authorized for emergency use, monitoring for potential adverse effects (e.g., cutaneous reactions) is necessary. The clinics of HHV-6 infection in COVID-19 pandemic: Pityriasis rosea and Kawasaki disease. Pityriasis Rosea as a Possible Complication of Vaccination Against COVID-19. 2023 Feb 9;11(2):397. doi: 10.3390/vaccines11020397. Patient concerns: Would you like email updates of new search results? Coronavirus disease 2019 and pityriasis rosea: A review of the immunological connection. Epub 2022 Jun 21. and transmitted securely. The patients/participants provided their written informed consent to participate in this study.
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