Pityriasis rosea-like eruptions following vaccination with BNT162b2 mRNA COVID-19 Vaccine. The .gov means its official. Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Clin Cosmet Investig Dermatol. Unable to load your collection due to an error, Unable to load your delegates due to an error. Do the medications have any side effects? Pityriasis rosealike rashes have been described after H1N1 influenza, HPV, diphtheria, poliomyelitis, smallpox, pneumococcal, hepatitis B and BCG vaccinations. Careers. Pityriasis rosea-like rash after messenger RNA COVID-19 vaccination: A case report and review of the literature. The https:// ensures that you are connecting to the The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Before doi: 10.1111/jdv.17342, 5. J Eur Acad Dermatol Venereol 2020;34:e4367. An official website of the United States government. Copyright 2021 Leerunyakul, Pakornphadungsit and Suchonwanit. 2021 Aug;185(2):e34. and transmitted securely. Conflicts of Interests: The authors declare there are no competing interests. The herald patch is the telltale sign that your rash could be PR, but there are other common (though not universal) symptoms as well. Although the exact pathogenesis of PR remains unknown, the endogenous systemic reactivation of HHV (i.e., type 6 and 7) in the skin has been implicated as a precipitating factor. Pityriasis rosea-like eruption after Pfizer-BioNTech COVID-19 vaccination. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. 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. Drug-induced PR-like eruption accounts for 2% of all cutaneous adverse drug reactions (10). 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. Cyrenne BM, Al-Mohammedi F, DeKoven JG, Alhusayen R. J Eur Acad Dermatol Venereol. Clipboard, Search History, and several other advanced features are temporarily unavailable. (2020) 33:e13878. The exanthem was self-limited in both patients over a period of a month. I figured a very determined mosquito had snuck into my room and attacked me through my tank top. 8600 Rockville Pike Of the 30 cases found, none experienced severe adverse effects and the rash resolved in an average of 5.6 weeks. "And it has a particular [dermatomal] distribution because it's along a nerve," which also presents as fluid-filled blisters, rather than lesions. Here, we describe a case of PR-like eruption following ChAdOx1 nCoV-19 (AZD1222) vaccination in a Thai patient with glioblastoma. However, there isnt enough research to determine that stress may cause pityriasis rosea. Blood tests to check for causes of a rash that arent related to pityriasis rosea. Br J Dermatol. Epub 2020 Nov 20. About one to two weeks later, discolored circular or oval-shaped patches appear in groups near the herald patch. Although the exact pathogenesis of PR is unknown, current evidence suggests that an inflammatory reaction due to a viral trigger may lead to the cutaneous manifestations. The .gov means its official. 2021 Dec;108(6):317-318. doi: 10.12788/cutis.0411. A 3-cm oval plaque with peripheral scale, larger than the other lesions, was present on the inferior portion of the right breast. Vaccine-induced pityriasis rosea and pityriasis rosea-like eruptions: a review of the literature. Would you like email updates of new search results? Pityriasis rosea-like eruption after Pfizer-BioNTech COVID-19 vaccination. Get useful, helpful and relevant health + wellness information. -, Drago F, Ciccarese G, Javor S, Parodi A. Vaccineinduced pityriasis rosea and pityriasis rosealike eruptions: a review of the literature. Pityriasis rosea (PR)-like eruption is a cutaneous complication associated with several medications and vaccinations. Dermatol Ther. MeSH In: Jameson J, Fauci AS, Kasper DL, et al., eds. However, a fungus causes ringworm. NCI CPTC Antibody Characterization Program, Ehsani AH, Nasimi M, Bigdelo Z. Pytiriasis rosea as a cutaneous manifestation of COVID-19 infection. It looked like one, and it certainly itched like one but then more came. COVID-19 has been reported as one such viral trigger for PR. -, Drago F, Ciccarese G, Parodi A. Pityriasis rosea and pityriasis rosealike eruptions: how to distinguish them? doi: 10.1097/MD.0000000000029823. SARS-CoV-2 spike protein positivity in pityriasis rosea-like and urticaria-like rashes of COVID-19. I tell my patient to use a gentle non-soap cleanser." The authors have no conflicts of interests to disclose. Safety and efficacy of the BNT162b2 mRNA Covid19 vaccine. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination: A systematic review and meta-analysis. The site is secure. Br J Dermatol. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination: A systematic review and meta-analysis. What started as a single, quarter-inch raised welt on my left rib cage eventually morphed into two, then four. The site is secure. 2022 May;121(5):1003-1007. doi: 10.1016/j.jfma.2021.12.028. It could be pityriasis rosea here's how to treat it. (2021) 35:e4913. J Eur Acad Dermatol Venereol 2020;34:e2123. Unable to load your collection due to an error, Unable to load your delegates due to an error. Apply a moisturizer, calamine lotion or a nonprescription . Clinical findings of pityriasis rosealike, Clinical findings of pityriasis rosealike eruption in the patients. Europe PMC is an archive of life sciences journal literature. doi: 10.1111/jdv.17342. Under the treatment that was initiated a partial remission of the lesions after 7 days was observed. 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. With COVID-19 vaccines being authorized for emergency use, monitoring for potential adverse effects (e.g., cutaneous reactions) is necessary. However, some people believe that eating an anti-inflammatory diet may relieve itching. Sriphojanart T, Khunkhet S, Suchonwanit P. A retrospective comparative study of the efficacy and safety of two regimens of diphenylcyclopropenone in the treatment of recalcitrant alopecia areata. A woman. J Eur Acad Dermatol Venereol. COVID-19-associated pityriasis rosea in children: Case report and literature review. Cured meats with nitrates, such as hot dogs. 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-like eruptions following COVID-19 mRNA-1273 vaccination: A case report and literature review. Get many smaller patches or bumps on your skin. -, Carballido Vzquez A.M., Morgado B. Pityriasis rosea-like eruption after Pfizer-BioNTech COVID-19 vaccination. 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. 2021 Jul;85(1):46-55. doi: 10.1016/j.jaad.2021.03.092. Generalized Papulovesicular Eruption as a Side Effect of the Pfizer-BioNTech COVID-19 Vaccine. A case of Pityriasis rosea is presented in a 66-year-old black male 1 week after administration of the Pfizer-BioNTech COVID-19 vaccine. This Month in JAAD International: August 2022: Cutaneous reactions to COVID-19 messenger RNA booster dose vaccination. Pityriasis rosea Gibert type rash in an asymptomatic patient that tested positive for COVID-19. Parakeratosis with minimal acanthosis and spongiosis of the epidermis. A virus may cause pityriasis rosea, but experts arent sure. The site is secure. Pityriasis rosea, pityriasis rosea-like eruptions, and herpes zoster in the setting of COVID-19 and COVID-19 vaccination. Authors Lina Abdullah 1 Various mild and benign cutaneous manifestations of the different forms of the COVID-19 vaccine have been documented. In approximately 50% of people with pityriasis rosea, the patches itch. Pityriasis Rosea Associated With COVID-19 Vaccination: A Common Rash Following Administration of a Novel Vaccine. Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Clin Cosmet Investig Dermatol. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Healthcare experts believe herpesvirus 6 (HHV-6), HHV-7 and/or HHV-8 cause pityriasis rosea, but there arent any conclusive studies. Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature. Despite this rare complication, our report highlights that the presence of PR-like eruption is not a contraindication for subsequent vaccinations. -, Polack FP, Thomas SJ, Kitchin N et al. The authors have no conflicts of interest to declare. 2021 Dec;108(6):317-318. doi: 10.12788/cutis.0411. Pityriasis rosea, COVID-19 and vaccination: new keys to understand an old acquaintance. Some rare cases can take up to three months. Unauthorized use of these marks is strictly prohibited. Some research shows that people who follow a Mediterranean diet have lower levels of inflammation in their bodies. While you don't need to treat the rash, some patients ask for treatment to take care of the following. However, if you scratch your patches, you may break your skin, leading to an infection that can cause pain. Epub 2021 Apr 26. (2016) 55:e33843. If you have pityriasis rosea, the rash with go away without treatment. Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Histopathologic features: (B) microscopic image at a low power field showing psoriasiform epidermal hyperplasia, perivascular infiltration, and interface dermatitis (hematoxylin-eosin; scale bar represents 100 m); (C) microscopic image at a high power field showing focal spongiotic dermatitis, interface dermatitis, and perivascular infiltration of lymphocytes and eosinophils (hematoxylin-eosin; scale bar represents 40 m). Lessons: Epub 2021 Aug 7. "It looks very different.". Cutis. The https:// ensures that you are connecting to the The Covid Symptom Study. If you develop symptoms of pityriasis rosea while pregnant, contact your healthcare provider right away. and transmitted securely. National Library of Medicine However, after 14 days, she developed multiple discrete blanching erythematous oval patches and plaques on the lower abdomen, back, and bilateral upper thighs (Figures 1A,B). Bethesda, MD 20894, Web Policies Characterization of the inflammatory cell infiltrate in herald patches and fully developed eruptions of pityriasis rosea. 2021 Jun 25;118(25):431. doi: 10.3238/arztebl.m2021.0257. 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. The site is secure. The cause of pityriasis rosea is not known, but it is commonly believed to be caused by a virus or bacteria. Would you like email updates of new search results? Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: a registry-based study of 414 cases. Urbina F, Das A, Sudy E. Clinical variants of pityriasis rosea. -, Drago F, Ciccarese G, Rebora A, Parodi A. 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). The patient had a positive RT-PCR result, and was confirmed with SARS-CoV-2 infection. Bethesda, MD 20894, Web Policies 2021 Sep;60(9):1150-1151.doi: 10.1111/ijd.15700. 2022 Nov 6;15:2369-2382. doi: 10.2147/CCID.S388245. Refined carbohydrates, such as sugar, pastries and white bread. 2021 Aug;185(2):e34. 2022 May;11(2):222-225. doi: 10.7774/cevr.2022.11.2.222. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753512/), Visitation, mask requirements and COVID-19 information, sexually transmitted disease or infection. 2021;35(8):e489e491. Pityriasis rosea is a benign inflammatory rash that starts with a single red rash, also known as the "herald patch," which eventually gives way to a larger, similar-looking rash on the trunk within days or weeks, says dermatologist Corey L. Hartman, founder of Skin Wellness Dermatology in Birmingham, Alabama. Suchonwanit P, Rojhirunsakool S, Khunkhet S. A randomized, investigator-blinded, controlled, split-scalp study of the efficacy and safety of a 1550-nm fractional erbium-glass laser, used in combination with topical 5% minoxidil versus 5% minoxidil alone, for the treatment of androgenetic alopecia. Patient concerns: 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. The site is secure. Once its gone, you likely wont develop it again. (a) Patient 1: Thin, Histopathological findings of pityriasis rosealike, Histopathological findings of pityriasis rosealike eruption in patient 1. Herald patch in the right hypochondrium followed by typical oval-shaped secondary plaques, Pityriasis rosea lesions on the upper extremities, MeSH 2005;124(6):12341240. Foods that have anti-inflammatory properties include: Foods that may increase inflammation include: There isnt any way to prevent pityriasis rosea. It has been reported that pityriasis rosea has been triggered by several vaccines, as a rare side-effect. Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. This patch is the herald or mother patch. eCollection 2022. official website and that any information you provide is encrypted JAAD Int. Learning points: 2020 Sep 25;155(6):273. doi: 10.1016/j.medcli.2020.05.024. These skin conditions can include, among other things, hives, measles-like rashes and a full body rash similar to pityriasis rosea. 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. Br J Dermatol. If you have a very itchy rash, your healthcare provider may prescribe the following to help relieve your symptoms: There are several over-the-counter products or home remedies that can help stop your rash from itching. . Disseminated erythematous-papulosquamous lesions, with right. Clipboard, Search History, and several other advanced features are temporarily unavailable. Some treatments can alleviate related symptoms, including itching. doi: 10.1016/j.jdcr.2018.04.002, 12. These types cannot cause cold sores or genital herpes. Would you like email updates of new search results? Physical examination revealed that lesions were distributed along cleavage lines, similar to PR, without herald patch or prominent scales (Figure 1C). Please enable it to take advantage of the complete set of features! 2022 Nov;36(11):1947-1968. doi: 10.1111/jdv.18294. Numerous scattered erythematous plaques with fine scale oriented along skin cleavage, Herald patch of pityriasis rosea. An official website of the United States government. sharing sensitive information, make sure youre on a federal doi: 10.1111/jdv.17498. An official website of the United States government. Studies show that some skin conditions may appear with COVID-19, including pityriasis rosea. Keywords: 2021 Dec;108(6):317-318. doi: 10.12788/cutis.0411. 2022 Jul 21;14(7):e27108. The mechanisms behind these COVID-19-related symptoms remain unclear. Disclaimer. (2021) 60:11501. (a) haematoxylineosin, original magnification 10. eCollection 2022 Feb. Kroumpouzos G, Paroikaki ME, Yumeen S, Bhargava S, Mylonakis E. Microorganisms. 2022 Sep-Oct;40(5):586-590. doi: 10.1016/j.clindermatol.2022.01.002. Moreover, COVID-19 may solely induce human herpesvirus reactivation through the immunomodulatory ability of SARS-CoV-2 to reactivate latent viruses (8, 9). Pityriasis Lichenoides. Cutis. Patient concerns: Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. Federal government websites often end in .gov or .mil. Unauthorized use of these marks is strictly prohibited. FOIA | Pityriasis Rosea, COVID-19 and . Herald patch of pityriasis rosea. Shabazz DR. Pityriasis Rosea. Unable to load your collection due to an error, Unable to load your delegates due to an error. See this image and copyright information in PMC. "Covid arm," a red, rashlike skin reaction that can occur at the injection site days after inoculation, has been well-publicized. Careers. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The typical distribution of the rash is on the trunk between the neck and the knees.". It is likely that a new viral trigger of pityriasis rosea is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. (2021) 93:18501. In a registry-based study, PR-like eruption was observed in only 12% of patients (14). Influenza viruses and vaccines have triggered pityriasis rosea in some cases.". Temiz SA, Abdelmaksoud A, Dursun R, Durmaz K, Sadoughifar R, Hasan A. J Cosmet Dermatol. (2006) 12:1. doi: 10.5070/D380D8301D, 11. Birlutiu V, Dobritoiu ES, Lupu CD, Herteliu C, Birlutiu RM, Dragomirescu D, Vorovenci A. Pityriasis rosea commonly affects the skin on your trunk, arms or legs. Br J Dermatol 2021. New York City-based dermatologist Macrene Alexiades. official website and that any information you provide is encrypted Bin Rubaian NF, Almuhaidib SR, Aljarri SA, Alamri AS. Washrawirul C, Triwatcharikorn J, Phannajit J, Ullman M, Susantitaphong P, Rerknimitr P. J Eur Acad Dermatol Venereol. 2023 Cond Nast. Eczema, Psoriasis, Cutaneous Infections, Acne, and Other Common Skin Disorders. sharing sensitive information, make sure youre on a federal (No.) (2020) 33:e13650. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases. While my particular flare-up itched a lot, that's not always the case. eCollection 2022 Jul. Pityriasis rosea: An update on etiopathogenesis and management of difficult aspects. Pityriasis rosea-like rash after messenger RNA COVID-19 vaccination: A case report and review of the literature. 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. Bathe or shower in lukewarm water. Sprinkle bath water with an oatmeal-based bath product (Aveeno). Many Americans become infected with them at an early age. This tiny glimpse of her natural texture is thrilling. Clipboard, Search History, and several other advanced features are temporarily unavailable. The .gov means its official. Ad Choices. Treatment was initiated with systemic corticosteroid therapy - hydrocortisone hemisuccinate 200 mg/day for 7 days, and loratadine 10 mg 2 times a day. Of the reported cases, 96.7% were secondary to the Pfizer vaccine, with only 1 reported . Six cases of pityriasis rosea following SARS-CoV-2 vaccination with BNT162b2. Other plausible theories include molecular mimicry with viral epitopes and type IV delayed hypersensitivity reaction (12). McMahon DE, Amerson E, Rosenbach M, Lipoff JB, Moustafa D, Tyagi A, Desai SR, French LE, Lim HW, Thiers BH, Hruza GJ, Blumenthal KG, Fox LP, Freeman EE. Epub 2020 Jun 29. 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. Authors B M Cyrenne 1 , F Al-Mohammedi 1 , J G DeKoven 1 , R Alhusayen 1 Affiliation Unauthorized use of these marks is strictly prohibited. The papulovesicular and pityriasis rosea . Interventions: The patient presented to the Department of Dermatology for a 3 week duration of an extremely pruritic erythematous-squamous lesion, initially on the trunk and upper limbs, with extension to the lower limbs in the last week and the lesion respected the cephalic extremity, palms, and soles. However, adverse effects to COVID-19 vaccines, particularly cutaneous reactions, have been reported. Pearls and pitfalls: Adverse cutaneous reactions after COVID-19 vaccination. J Invest Dermatol. 1. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article. eCollection 2022. In conclusion, we have described the first case of PR-like eruption following ChAdOx1 nCoV-19 (Oxford/AstraZeneca) vaccination. The .gov means its official. 2022 Feb 20;14(2):e22414. Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review. eCollection 2022. Skin lesions appeared in a 49-year-old female 8 days after the first dose of the BNT162b2 mRNA vaccine and in a 53-year-old male 7 days after the second dose of the same . Disclaimer. Like previously reported cutaneous eruptions associated with COVID-19 infection, these cases "raise more questions than . Martn Enguix D, Salazar Nievas MDC, Martn Romero DT. 2022 Nov 1;43(6):555-558. doi: 10.2500/aap.2022.43.220058. 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.