This suppressed and dysregulated immune state may trigger the reactivation of latent viral infections, such as HHV 6 and HHV 7. The viral pathophysiology of SARS-CoV-2 is characterized by the simultaneous occurrence of cytokine release and immunosuppression. In the case of infection, a cytokine storm is observed, while in the case of immunization the released cytokines are in the frame of immune stimulation. It is unclear if the pathophysiology leading to PR is the same. SARS-CoV-2 infection as well as immunization with COVID-19 vaccines have been associated with cases of cutaneous adverse events, including PR and PR-LE.
Pinpoint rash on 9 year old abdomen skin#
PR is a self-limiting papulosquamous skin disorder where the reactivation of latent human herpes virus (HHV 6/7) infection is considered the most likely etiological agent. His rash resolved completely over a period of 4 weeks. The itching was self-limiting and therefore the patient did not receive any antihistamines. His medical history included transient ischemic attacks, coronary artery disease, and dyslipidemia, for which he was taking medication. Within 48 hours, it had extended to his extremities ( Fig. The lesions had appeared 7 days after the second dose of the BNT162b2 vaccine. A herald annular plaque was observed on his upper abdomen and a diagnosis of PR was made.
On communication 2 weeks later, she reported no vaccine-related side-effects.Ī 53-year-old Caucasian male presented with an itchy macular rash on his upper trunk and abdomen. She received a delayed second dose of the vaccine, 45 days after the first dose, when no lesions remained. Her rash gradually improved and at follow-up, 4 weeks later, it had resolved completely. She was treated with oral antihistamines and topical betamethasone 0.1%, with clinical improvement. On clinical examination, she was afebrile and her skin lesions were compatible with a diagnosis of PR.
Pinpoint rash on 9 year old abdomen Patch#
Herald patch in the right hypochondrium followed by typical oval-shaped secondary plaques Here we report two cases of PR which developed following the administration of BNT162b2 (BioNTech, Mainz, Germany Pfizer, New York City, NY, USA) vaccine. The activation of immunological mechanisms triggers PR in both cases: infection and vaccination.
The precise etiopathogenesis of PR remains largely unknown and its etiology is hypothesized to be multifactorial, including both infective and non-infective factors, such as autoimmunity and atopy. The disease starts with the sudden appearance of a single erythematous patch known as the ‘herald patch’, which is followed by secondary scaly lesions with the characteristic ‘Christmas tree’ distribution on the cleavage lines.
It affects approximately 0.5–2% of the general population and appears to be more common in young adults than in the elderly and children. PR is a self-limiting benign skin disorder commonly seen in clinical practice. Vaccination-induced cases of PR by other vaccines have also been reported in the past. A large body of evidence has emerged in late 2021 to show that SARS-CoV-2 infection and COVID-19 vaccines are associated with skin disorders, including pityriasis rosea (PR) and pityriasis rosea-like eruptions (PR-LE). The efficacy and safety of COVID-19 vaccines are currently a scientific priority.
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