Plaque Psoriasis Exacerbation and COVID-19 Vaccination: Assessing the Characteristics of the Flare and the Exposome Parameters

Author:

Karampinis Emmanouil1ORCID,Papadopoulou Myrto-Maria2ORCID,Chaidaki Kleoniki1,Georgopoulou Konstantina-Eirini3,Magaliou Stavroula4,Roussaki Schulze Angeliki Viktoria1,Bogdanos Dimitrios P.5ORCID,Zafiriou Efterpi1ORCID

Affiliation:

1. Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece

2. Department of Internal Medicine, General Hospital of Karditsa, 43131 Karditsa, Greece

3. Department of Dermatology, General Hospital of Nikaia Pireus “Agios Panteleimon”—General Hospital of West Attica “Agia Varvara”, 12351 Athens, Greece

4. Department of Internal Medicine, General Hospital of Trikala, 42100 Trikala, Greece

5. Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece

Abstract

The diverse patient population and widespread vaccination in the COVD-19 era make vaccine-triggered episodes of psoriasis an ideal model of exposome research. This scenario explores the fine balance between protective and exacerbating factors, providing insights into the complex relationship between environmental exposure and psoriasis immunopathogenesis when a trigger appears, such as that of the hyperinflammatory state induced by the COVID-19 vaccine. Analyzing interactions between vaccine-induced phenomena and exposome parameters may provide clinically relevant information important for personalized medicine decision-making. We performed a literature review seeking patients with plaque psoriasis flares or new onset or change in plaque psoriasis into another psoriasis subtype, such as pustular or erythrodermic flare, focusing on the inner and external exposome traits of patients. We identified 71 patients with plaque psoriasis flares, 12 patients with new-onset psoriasis, and 17 with plaque psoriasis subtype change, and assessed the COVID-19 vaccine-induced plaque psoriasis in terms of clinical presentation, post-vaccination flare period and treatment status, as well as inner exposome parameters (genomics, oxidative stress, hormonal impact due to gender, aging, skin color) and external parameters (UV, infectomics). Novel data on psoriasis flares following COVID-19 vaccination are primarily obtained by combining exposome and vaccine-triggered episode features and characteristics and comparing them with similar psoriasis flares unrelated to COVID-19 vaccination.

Publisher

MDPI AG

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