Cutaneous Purpura Following Covid-19 Vaccination

Background: Vasculitis exacerbation has been reported secondary to multiple vaccines. However, this relationship is rare and it has yet to be determined. Case history: A 67-year-old male presented to our hospital with a sudden eruption of pruritic, erythematous-to-violaceous purpura and plaques distributed along the lower and upper extremities and low back. Ten days prior he was vaccinated with Vaxzevria. No systemic involvement was perceived. He had no prior history of allergy or purpuric skin eruption and had not recently started any new medication. Laboratory tests (included autoimmunity screening) and instrumental examinations were normal, except for a mild pericardial effusion. Biopsies obtained from the left arm both showed a picture compatible with leucocytoclastic vasculitis. After discussing risks and benefits the patient was discharged with topical steroids and a prednisone taper. Discussion: A possible mechanism of vasculitis following vaccination might be vessel damage likely secondary to abnormal immunological activation with vaccine-related antigens promoting antibody development and immune complex deposition. Data from literature showed that cutaneous adverse reactions from COVID-19 vaccine were rare, all mild and characterized by rapid, and generally spontaneous resolution. It is important for healthcare providers to be aware that the COVID-19 vaccine can potentially precipitate or exacerbate cutaneous inflammation.

PDF HTML