Epub 2020 Nov 9. All rights reserved. Garca-Gil M.F., lvarez-Salafranca M., Martnez Garca A., Ara-Martn M. Generalized granuloma annulare after pneumococcal vaccination. The authors report the first case of generalized granuloma annulare associated with pneumococcal vaccination in a 57-year-old woman, who presented cutaneous lesions 12 days after vaccination. The second patient was a 31 years-old woman with an annular, irregular, pink-colored erythematous 32 in diameter papular lesion on the dorsum of the left foot, arising ten days after an RT-PCR SARS-CoV-2 positive test. She endorsed mild pruritus. Clin Exp Dermatol. FIGURE 1 Immunohistochemical staining of granuloma annulare in biopsies from pre and postCOVID19 patients. Granuloma annulare (GA) is a benign, self-limited skin condition of unknown etiology. Additionally, the patient experienced the flare less than 1week after receiving the COVID-19 booster dose, which fact further supported the correlation between the vaccine and her disease. 401,887 people reported to have side effects after getting Pfizer BioNTech Covid Vaccine. A real-time polymerase chain reaction test result for SARS-CoV-2 was positive. At followup 2months later, there was a reduction and flattening of the skin lesions (Fig 3). Kakurai M., Kiyosawa T., Ohtsuki M., Nakagawa H. Multiple lesions of granuloma annulare following BCG vaccination: case report and review of the literature. Bethesda, MD 20894, Web Policies Please enable it to take advantage of the complete set of features! Bethesda, MD 20894, Web Policies Cutaneous reactions to vaccinations - PubMed Generalized granuloma annulare after COVID-19 vaccination government site. J. Dermatol. Reactogenicity is defined as a subset of reactions occurring shortly after vaccination, including local signs and symptoms, such as pain, redness, swelling and induration, and systemic manifestations, such as fever, . Cutaneous reactions reported after Moderna and Pfizer SARS-COV-2 vaccination: a registry-based study of 414 cases. Meo SA, Bukhari IA, Akram J, Meo AS, Klonoff DC. Some reports may have incomplete information. Current evidence shows that most cutaneous reactions secondary to SARS-CoV-2 vaccination are like those associated with SARS-CoV-2 infection and share immunopathological mechanisms, including host immune activation against viral particles rather than direct viral damage [14], [19]. 2A-D). Granuloma annulare may be caused by multiple triggers. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. In dermatopathological practice, it should be aware of the . Unauthorized use of these marks is strictly prohibited. 2021 Feb;25(3):1663-1669. doi: 10.26355/eurrev_202102_24877. Skin manifestations associated with SARS-COV-2. Careers. Calabria E., Canfora F., Mascolo M., Varricchio S., Mignogna M.D., Adamo D. Autoimmune mucocutaneous blistering diseases after SARS-Cov-2 vaccination: a case report of Pemphigus Vulgaris and a literature review. A. Some are directly related to the injection of a live attenuated virus, such as varicella or vaccinia (for immunity to smallpox), whereas others cause more nonspecific erythema and swelling at the injection site, as a result of local inflammation or irritation. Disclaimer. A Case of Leukocytoclastic Vasculitis Following SARS-COV-2 Vaccination. FOIA Generalized granuloma annulare after COVID-19 vaccination JAAD Case Rep. 2022 May 14;25:18-21. doi: 10.1016/j.jdcr.2022.05.003. Please enable it to take advantage of the complete set of features! A reddish lesion on left arm; B. doi: 10.1111/1346-8138.15594. It is also possible that threshold titers of a stimulatory antigen were not present until after the second vaccine dose or that immunologic memory was nave until the second dose; initial testing of the Pfizer and Moderna vaccines showed that a relatively weak immune response was elicited after the first dose; a more robust response followed, when the second dose was given.10 This may be the reason why the patient experienced a flare only after her second dose and is the reason why current guidelines recommend a 2-dosage schedule for the aforementioned COVID-19 vaccines. Granuloma annulare - Diagnosis and treatment - Mayo Clinic Autoimmune mucocutaneous blistering diseases after SARS-Cov-2 vaccination: A Case report of Pemphigus Vulgaris and a literature review. Elsevier; 2017. Granuloma annulare after SARS-CoV-2 vaccination: A case report and a literature review. 1B). Histologically, mainly GA presents a palisading pattern, characterized by a central zone of necrobiotic collagen surrounded by palisading histiocytes and varying numbers of lymphocytes, and an interstitial pattern, characterized by histiocytes and lymphocytes distributed between collagen bundles and around vessels with an increased amount of connective tissue mucin [3], [4]. Epub 2021 Sep 8. Introduction. See this image and copyright information in PMC. Introduction. it causes swelling, ulcerations, and loss of function of the large intestine), Urinary incontinence (inability to control the flow of urine and involuntary urination), Urinary retention (the inability to completely or partially empty the bladder), Urticaria (rash of round, red welts on the skin that itch intensely), Vaccination site erythema (redness around vaccination site), Vaccination site pruritus (severe itching of the skin at vaccination site), Vasculitis (inflammation of a blood vessel or blood vessels), Ventricular extrasystoles (premature cardiac contraction), Ventricular tachycardia (rapid heartbeat that originates in one of the lower chambers (the ventricles) of the heart), Vitreous floaters (spots before the eyes), Weight bearing difficulty (difficulty due to weight of thigh fat deposition), Wheezing (a high-pitched whistling sound made while you breath), Glipizide and Hydrocodone Bitartrate And Homatropine Methylbromide drug interaction, Loperamide Hydrochloride and Blopress drug interaction, Rash Macular (small, flat red spots): 4 people, 9.76%, Fatigue (feeling of tiredness): 3 people, 7.32%, Headache (pain in head): 2 people, 4.88%, Malaise (a feeling of general discomfort or uneasiness): 2 people, 4.88%. All rights reserved. Generalized granuloma annulare after COVID-19 vaccination Epub 2022 Apr 10. sharing sensitive information, make sure youre on a federal Would you like email updates of new search results? Granuloma annulare in Moderna COVID Vaccine, Granuloma annulare in Johnson & Johnson COVID Vaccine, Abortion spontaneous (naturally occurring miscarriage), Acute myocardial infarction (acute heart attack), Acute upper airway obstruction (blockage occurs in the upper airway), Ageusia (loss of taste functions of the tongue), Agitation (state of anxiety or nervous excitement), Alopecia areata (patchy baldness that typically begins with rapid hair loss), Anaphylaxis (serious allergic reaction that is rapid in onset and may cause death), Angioedema (rapid swelling of the dermis), Appendicitis (inflammation of the appendix), Appetite - decreased (decreased appetite occurs when you have a reduced desire to eat), Appetite - increased (increased appetite is when you want to eat much more often or in larger quantities than your body requires), Ards (acute respiratory distress syndrome) (sudden failure of the respiratory (breathing) system), Arthritis (form of joint disorder that involves inflammation of one or more joints), Asthenopia (eyestrain-tiredness of the eyes caused by prolonged close work by a person with an uncorrected vision problem), Atelectasis (partial or complete collapse of the lung), Atrial fibrillation/flutter (atrial fibrillation and flutter are abnormal heart rhythms in which the atria, or upper chambers of the heart, are out of sync with the ventricles), Autoimmune disorder (a condition in which the immune system attacks the body's normal substances and tissue), Autonomic nervous system imbalance (autonomic nervous system is of net equal emphasis), Basedow's disease (autoimmune disease where the thyroid is overactive, producing an excessive amount of thyroid hormones), Belching (release of gas from the digestive tract), Blindness transient (sudden loss of vision), Blister (small pocket of fluid within the upper layers of the skin caused by forceful rubbing (friction), burning, freezing, chemical exposure), Blood thyroid stimulating hormone decreased, Blood thyroid stimulating hormone increased, Bradycardia (abnormally slow heart action), Breast lump (localized swelling that feels different from the surrounding breast tissue), Bronchitis (inflammation of the mucous membrane in the bronchial tubes), Bundle branch block right (absence of transmission of electric impulses from the atrioventricular (av) bundle of his to the right ventricle), Bursitis (inflammation of a bursa, typically one in the knee, elbow, or shoulder), Canker sores (painful, open sore in the mouth), Cardiomyopathy (weakening of the heart muscle), Cardio-respiratory arrest (sudden dysfunction of heart and lungs), Cerebral haemorrhage (bleeding within the brain), Cerebral infarction (less blood supply to brain resulting tissue damage), Cerebral thrombosis (blood clot in brain), Chapped lips (cracking, fissuring, and peeling of the skin f lip), Chronic obstructive pulmonary disease (a progressive disease that makes it hard to breathe), Cognitive disorder (mental health disorders affects learning, memory, perception, and problem solving), Concussion (short loss of normal brain function in response to a head injury), Coronary artery occlusion (complete obstruction of blood flow in a coronary artery), Coronary heart disease (narrowing or blockage of the coronary arteries), Crohn's disease (condition that causes inflammation of the gastrointestinal tract), Deep venous thrombosis (blood clot in a major vein that usually develops in the legs and/or pelvis), Dehydration (dryness resulting from the removal of water), Dermatitis (inflammation of the skin resulting from direct irritation by an external agent or an allergic reaction to it), Dermatitis contact (skin reaction (dermatitis) resulting from exposure to allergens), Diabetic ketoacidosis (diabetic ketoacidosis (dka) is high concentrations of ketone bodies), Diverticulitis (digestive disease which involves the formation of pouches (diverticula) within the bowel wall), Drooling (drop saliva uncontrollably from the mouth), Dyskinesia (abnormality or impairment of voluntary movement), Ear pruritus (pruritus or itching is ""the unpleasant skin sensation that frequently provokes scratching"" in ear), Eczema (patches of skin become rough and inflamed, with itching and bleeding blisters), Ejection fraction (the percentage of blood that is pumped out of a filled ventricle as a result of a heartbeat), Ejection fraction decreased (systolic heart failure), Encephalopathy (functioning of the brain is affected by some agent or condition), Euphoric mood (excessively happy but may become angry or irritable), Eyelid ptosis (falling of the upper or lower eyelid), Eyelid twitch (spontaneous and uncontrolled spasms of the muscles), Facial paralysis (loss of function of face muscle), Facial paresis (weakness in facial muscle movement), Fainting (loss of consciousness and postural tone), Feeding disorder (when children refuse to eat certain food groups), Fibromyalgia (a long-term condition which causes pain all over the body), Flank pain (a distressing sensation experienced around the lower back and the upper abdomen), Flatulence (flatus expelled through the anus), Fluid retention (an abnormal accumulation of fluid in the blood), Formication (a sensation that exactly resembles that of small insects crawling on (or under) the skin), Gastroesophageal reflux disease (a condition in which stomach contents leak backward from the stomach into the oesophagus), Gastrointestinal disorder (functional problems of gastrointestinal tract), Gastrointestinal haemorrhage (bleeding gastrointestinal tract), Gaze palsy (disorders affecting the ability to move both eyes in the same direction), General physical health deterioration (weak health status), Glossodynia (a burning or painful sensation in the tongue), Gout (uric acid crystals building up in the body), Guillain-barre syndrome (the body's immune system attacks its peripheral nervous system), Haematochezia (passage of stools containing blood), Haematoma (collection of blood outside the blood vessels), Hallucinations (sensations that appear real but are created by your mind), Heart palpitations (feelings or sensations that your heart is pounding or racing), Hemiparesis (weakness on one side of the body), Hemiplegia (paralysis of one side of the body), Herpes simplex (herpes simplex is a common viral infection), Hyperacusis (disorder in loudness perception), Hyperhidrosis (abnormally increased sweating), Hyperkalemia (damage to or disease of the kidney), Hyperthyroidism (over activity of the thyroid gland), Hypervolaemia (abnormally increased volume of blood), Hypoaesthesia (reduced sense of touch or sensation), Hypoaesthesia oral (reduced sense of touch or sensation in mouth), Hyponatremia (abnormally low level of sodium in the blood; associated with dehydration), Hyporesponsive to stimuli (abnormally low degree of responsiveness on an agent, action, or condition), Hypotension (abnormally low blood pressure), Hypothyroidism (abnormally low activity of the thyroid gland, resulting in retardation of growth and mental development), Idiopathic pulmonary fibrosis (chronic lung disease), Incoherent (talking in a confused and unclear way), Incontinence (lack of moderation or self-control), Injection site erythema (redness at injection site), Injection site haemorrhage (bleeding from injection site), Injection site nodule (small swelling or aggregation of cells in the body, esp. Histopathology was consistent with generalized and subcutaneous GA [8]. Keywords: Conclusions: J. Dermatol. Successful treatment of generalized granuloma annulare with pentoxifylline. Epub 2015 Feb 4. With medical big data and AI algorithms, eHealthMe is running millions of phase IV trials and makes the results available to the public. 2001;40:579581. Criado P.R., Pagliari C., Carneiro F.R.O., Quaresma J.A.S. An official website of the United States government. 2021;48(1):e1e2. -, Nomiyama T., Takenaka H., Kishimoto S., Katoh N. Granuloma annulare-like reaction to the bacillus Calmette-Gurin vaccination. McMahon D.E., Amerson E., Rosenbach M., Lipoff J.B., Moustafa D., Tyagi A., Desai S.R., French L.E., Lim H.W., Thiers B.H., Hruza G.J., Blumenthal K.G., Fox L.P., Freeman E.E. and transmitted securely. National Library of Medicine Epub 2022 Mar 5. 1997;36(5):340348. HHS Vulnerability Disclosure, Help Avallone G., Quaglino P., Cavallo F., Roccuzzo G., Ribero S., Zalaudek I., Conforti C. SARS-CoV-2 vaccine-related cutaneous manifestations: asystematic review. Generalized granuloma annulare after pneumococcal vaccination The use of the eHealthMe site and its content is at your own risk. [Granuloma annulare following BCG vaccination]. It has been postulated that molecular mimicry plays a role in this acute autoimmune response, with antibodies toSARS-CoV-2-spike glycoproteins cross-reacting withhost peptides that contain a similar protein arrangement.7,8 Talotta etal9 reasoned that those predisposed to autoimmune and autoinflammatory conditions, receiving a nucleic acid vaccine may be at risk for an adverse immunologic effect.9 In patients with autoimmune disease who have received a COVID-19 vaccination, severe adverse effects have not surpassed those experienced from receiving other age appropriate vaccines. J. The phase IV clinical study analyzes which people get Pfizer BioNTech Covid Vaccine and have Granuloma annulare. Bethesda, MD 20894, Web Policies Piette E.W., Rosenbach M. Granuloma annulare: clinical and histologic variants, epidemiology, and genetics. See this image and copyright information in PMC. government site. 2023 Feb;242:154300. doi: 10.1016/j.prp.2022.154300. Barbieri J.S., Rosenbach M., Rodriguez O., Margolis D.J. Treatment was initiated with an intramuscular injection of triamcinolone 40mg and clobetasol 0.05% topical cream with improvement 1month later, at which point she was started on hydroxychloroquine 200mg twice a day following clearance from an ophthalmologist. Rarely, vaccinations have been associated with generalized hypersensitivity reactions, such as erythema multiforme, Stevens-Johnson syndrome, urticaria, acute generalized exanthematous pustulosis, and drug hypersensitivity syndrome. Allergic contact dermatitis can develop at the injection site, typically due to adjuvant ingredients in the vaccine, such as thimerosal and aluminum. A 69-year-old woman developed a single reddish lesion on the left deltoid region, where the SARS-CoV-2 vaccine seven days earlier was injected. 2023 Apr;12(2):87-96. doi: 10.7774/cevr.2023.12.2.87. The exaggerated inflammatory response is linked to the triggering of innate and adaptive immune responses and to the monocytic-macrophage system [22]. * Approximation only. PMC Damsky W., Peterson D., King B. Granuloma annulare - Symptoms and causes - Mayo Clinic DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. [Granuloma annulare following BCG vaccination]. It appears as one or more self-regressing erythematous papules that tend to form annular or arciform plaques, localized mainly on the dorsum of hands and feet or over the trunk. Examination revealed multiple papules coalescing into plaques with central clearing on the back, flank, inguinal folds, and extremities (Fig 1). At dermoscopy, linear arborizing vessels, A. Careers. In most cases, the sizes of the lesions range from one to five centimeters. Accessibility In dermatopathological practice, it should be aware of the potential, though rare, of GA as a possible adverse event after vaccination, including the SARS-CoV-2 vaccination. The site is secure. A. Barbieri J.S., Rodriguez O., Rosenbach M., Margolis D. Incidence and prevalence of granuloma annulare in the United States. -, Piette E.W., Rosenbach M. Granuloma annulare: clinical and histologic variants, epidemiology, and genetics. Bookshelf Among these are vaccinations, which have been described as an infrequent cause of granuloma annulare. Although uncertain etiology, it could represent a hypersensitivity reaction to triggers such as trauma, medications, malignancy, viral infections, and vaccinations [2]. Generalized granuloma annulare sparing vaccination sites. official website and that any information you provide is encrypted Some of these reactions are due to nonspecific inflammation and irritation at the injection site, whereas other reactions are directly related to the live attenuated virus. Finally, allergic contact dermatitis can develop at the injection site, typically due to adjuvant ingredients in the vaccine, such as thimerosal and aluminum. The onset of certain inflammatory dermatologic conditions, such as lichen planus, granuloma annulare, and pemphigoid, were reported to occur shortly after vaccine administration. You can use the study as a second opinion to make health care decisions. Our phase IV clinical studies alone cannot establish cause-effect relationship. Inflammation in your skin causes a raised, discolored rash or lumps under your skin. doi: 10.1016/j.abd.2020.05.009. Bellinato F, Fratton Z, Girolomoni G, Gisondi P. Vaccines (Basel). Generalized granuloma annulare after COVID-19 vaccination Laboratory tests revealed a normal complete blood cell count, comprehensive metabolic panel, thyroid function, and hemoglobin A1c; HIV and hepatitis panels were negative. During the Cov-19 pandemic, many studies reported a broad spectrum of cutaneous reactions presenting as erythematous rashes or pernio-like, urticaria-like or vesicular/bullous patterns associated with Cov-19-infection and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. HHS Vulnerability Disclosure, Help Association of granuloma annulare with type 2 diabetes, hyperlipidemia, autoimmune disorders, and hematologic malignant neoplasms. Huynh T., Sanchez-Flores X., Yau J., Huang J.T. The phase IV clinical study analyzes which people get Pfizer BioNTech Covid Vaccine and have Granuloma annulare. Occurrence of erythema multiforme following COVID-19 vaccination: a review. Piette E.W., Rosenbach M. Granuloma annulare: clinical and histologic variants, epidemiology, and genetics. The nebulous nature of the etiology of GA is likely the culprit reason for our patient not experiencing generalized GA after her first dose of the vaccine. 2021 Apr 13;22(1):276. doi: 10.1186/s13063-021-05180-1. This hypothesis is reinforced by the description of GA in patients recently underwent other vaccinations, mainly Bacillus Calmette-Gurin (BCG) [2], [28].
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