Cutaneous reactions following COVID‐19 vaccination assessed by dermatologists: a single‐institutional study in Germany

Abstract

SummaryBackground and objectivesCutaneous reactions following COVID‐19 vaccination have been frequently described, whereas larger case series by dermatologists are lacking. This study assesses SARS‐CoV‐2 vaccination‐associated skin reactions, severity, treatment, course, eliciting vaccines, allergy test results and tolerance to revaccination.Patients and methodsSingle‐institutional, non‐interventional study of dermatologists assessing cutaneous manifestations in 83 patients in Germany.Results93 reactions were presented. Manifestations clustered into immediate (n = 51, 54.8%) and delayed hypersensitivity reactions (n = 10, 10.8%), chronic inflammatory skin diseases (n = 13, 14.0%), reactivation of latent herpes virus infection (pityriasis rosea/herpes zoster; n = 9; 9.7%) and others (n = 10, 10.8%). Vaccination was associated with new (76.3%) – mostly hypersensitivity reactions – or exacerbation of known skin diseases (23.7%), in this case predominantly chronic inflammatory skin diseases. Reactions occurred primarily within the first week (72.8%) and after first vaccination (62.0%). Treatment was required in 83.9% and hospitalization in 19.4%. In 48.8% revaccination led to recurrence of the same reactions. Disease was ongoing at last consultation in 22.6%, primarily in chronic inflammatory skin diseases. Allergy tests were performed in 15 patients (18.1%) and resulted negative.ConclusionsIt can be assumed that vaccination may trigger immune activation‐related reactions especially in those patients predisposed to develop respective skin diseases.