Despite this rare complication, our report highlights that the presence of PR-like eruption is not a contraindication for subsequent vaccinations. Cleveland Clinic is a non-profit academic medical center. It often presents with diffuse and confluent severely pruritic dusky-red erythematous lesions in the absence of herald patch (11). While it can spread all over the entire body, PR usually favors the trunk, says Christina Lam, an assistant professor of dermatology at Boston University School of Medicine and dermatologist at Boston Medical Center. -, Johansen M, Chisolm SS, Aspey LD, Brahmbhatt M. Pityriasis rosea in otherwise asymptomatic confirmed COVID-19-positive patients: a report of 2 cases. Influenza viruses and vaccines have triggered pityriasis rosea in some cases.". Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Various mild and benign cutaneous manifestations of the different forms of the COVID-19 vaccine have been documented. Epub 2022 Jun 21. If you have pityriasis rosea, you dont have to avoid any foods or drinks. American Academy of Dermatology's National Library of Dermatologic Teaching Slides. (c) Patient 2: Thin red to tan oval plaques with peripheral scale on the trunk and proximal thigh. Why not? Clipboard, Search History, and several other advanced features are temporarily unavailable. . 2021 Sep;60(9):1150-1151.doi: 10.1111/ijd.15700. Bookshelf 2023 Cond Nast. Alamri A, Alghamdi Y, Alamri SJ, Althaqafi MK, AlQurashi W, Bader BA, Mohanna AT, Almahdi B. Cureus. -, Drago F, Ciccarese G, Parodi A. Pityriasis rosea and pityriasis rosealike eruptions: how to distinguish them? . -, Drago F, Ciccarese G, Rebora A, Parodi A. Cutis. However, the studies dont conclusively prove that COVID-19 causes pityriasis rosea. About one to two weeks later, discolored circular or oval-shaped patches appear in groups near the herald patch. Many Americans become infected with them at an early age. Epub 2022 Jan 31. A woman. 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. Khalili M, Abtahi-Naeini B, Rastegarnasab F, Afshar K. Clin Case Rep. 2022 Jul 19;10(7):e6096. Keywords: adverse effect, coronavirus, cutaneous eruptions, immunization, pityriasis rosea, SARS-CoV-2, vaccine, case report, Citation: Leerunyakul K, Pakornphadungsit K and Suchonwanit P (2021) Case Report: Pityriasis Rosea-Like Eruption Following COVID-19 Vaccination. "It's usually not from head to toe that's more atypical but there are some people that get it more in the groin area or in the armpit rather than on the trunk predominantly, which is just a variant.". Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Clin Cosmet Investig Dermatol. Pityriasis Rosea Shortly After mRNA-1273 COVID-19 Vaccination. Though pityriasis rosea is a common skin rash, it can still make you feel self-conscious, and it can be unpleasant if it itches. This tiny glimpse of her natural texture is thrilling. Interventions: Foods that have anti-inflammatory properties include: Foods that may increase inflammation include: There isnt any way to prevent pityriasis rosea. Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Clin Cosmet Investig Dermatol. A virus may cause pityriasis rosea, but experts aren't sure. Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature. (a) Pityriasis rosea (chest, flank, and axilla); (b) pityriasis rosea (back). J Formos Med Assoc. doi: 10.1111/dth.13650, 7. Of the reported cases, 96.7% were secondary to the Pfizer vaccine, with only 1 reported . Dermatol Ther. Pityriasis Lichenoides. Numerous scattered erythematous, Pityriasis rosea. Clinical findings of pityriasis rosealike, Clinical findings of pityriasis rosealike eruption in the patients. -, Neoh CY, Tan AW, Mohamed K, et al. Federal government websites often end in .gov or .mil. Pityriasis rosea-like eruption revealing COVID-19. Before doi: 10.1111/dth.15601. While unusual, one patient developed pityriasis rosea once a year for five years in a row. Parakeratosis with minimal acanthosis and spongiosis of the epidermis. Numerous scattered erythematous plaques with fine scale oriented along skin cleavage lines, most appreciable on the upper portion of the chest. While home remedies are safe for most people, its a good idea to check with your healthcare provider before trying some of the following options. Case Report: Pityriasis Rosea-Like Eruption Following COVID-19 Vaccination. Kroumpouzos G, Paroikaki ME, Yumeen S, Bhargava S, Mylonakis E. Microorganisms. Histopathologic examination revealed epidermal focal spongiosis, interface dermatitis with necrotic keratinocytes, perivascular lymphocytic infiltration, and few eosinophilic infiltrations in the superficial dermis (Figures 3B,C). Some people see the rash disappear within 6 to 8 weeks, but it can take 5 months or longer for the skin to clear. doi: 10.1016/j.jaad.2021.03.092, 15. See this image and copyright information in PMC. Clinical findings of pityriasis rosealike eruption in the patients. Epub 2021 Jul 21. Pityriasis rosea after administration of Pfizer-BioNTech COVID-19 vaccine. sharing sensitive information, make sure youre on a federal 6 Called a "herald patch,". The https:// ensures that you are connecting to the -, Broccolo F., Drago F., Careddu A.M., et al. Pityriasis rosea: An update on etiopathogenesis and management of difficult aspects. eCollection 2022 Jul. Borgia F, Li Pomi F, Alessandrello C, Vaccaro M, Pioggia G, Gangemi S. J Dermatol. Among patients who received COVID-19 vaccines, PR-like eruptions have been reported following the first (n = 1) or second dose (n = 2) of BNT162b2 mRNA-based vaccines (3, 4). Epub 2021 May 10. 2021;35(9):e546e548. 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. National Library of Medicine The authors of one 2014 case report of a 71-year-old man who suffered from pityriasis rosea one month after receiving an influenza vaccine concluded that "altered immunity" could result in reactivation of HHV-6 and/or HHV-7 which may have triggered an atypical presentation of PR. 2022 Aug;87(2):295. doi: 10.1016/j.jaad.2022.06.036. However, some people believe that eating an anti-inflammatory diet may relieve itching. Pityriasis rosea usually resolves on its own without treatment in most cases, King says, but topical corticosteroids can be used for itchy control if necessary, which is what I used. Received: 03 August 2021; Accepted: 17 August 2021; Published: 07 September 2021. JAAD Int. (a) haematoxylineosin, original magnification 10. How quickly did it come on, and did my boyfriend also have it? See this image and copyright information in PMC. Shabazz DR. Pityriasis Rosea. Histopathological Patterns of Cutaneous Adverse Reaction to Anti-SARS-CoV-2 Vaccines: The Integrative Role of Skin Biopsy. Physicians should be aware that pityriasis rosea is a rare side-effect of COVID-19 vaccination.Pityriasis rosea is self-limiting and no medical treatment is usually required. sharing sensitive information, make sure youre on a federal Polack FP, Thomas SJ, Kitchin N, et al. Pityriasis rosea, pityriasis rosea-like eruptions, and herpes zoster in the setting of COVID-19 and COVID-19 vaccination. Central dusky-red erythematous on some plaques (A); almost all lesions fading with associated post-inflammatory hyperpigmentation after treatment (B). 2021;185(2):e34. 2022 Nov 6;15:2369-2382. doi: 10.2147/CCID.S388245. Our expert physicians and surgeons provide a full range of dermatologic, reconstructive and aesthetic treatments options at Cleveland Clinic. 8600 Rockville Pike Its important to pay attention to your skin. Med. The Covid Symptom Study. The evolution was unfavorable, with the spread of the lesions and the accentuation of the pruritus. Hardin J. Pityriasis Rosea. doi: 10.1007/s10103-019-02783-8, 16. One case of pityriasis rosea is reported in a patient infected with COVID-19, and the most commonly reported features are exanthomatous rash, urticaria, chickenpox like vesicles, petechiae, and acute hemorrhagic edema of infancy. Bethesda, MD 20894, Web Policies J Eur Acad Dermatol Venereol. Australas J Dermatol. (2021) 35:e5468. Pityriasis rosea-like rash after messenger RNA COVID-19 vaccination: A case report and review of the literature. sharing sensitive information, make sure youre on a federal Pityriasis rosea-like eruption after Pfizer-BioNTech COVID-19 vaccination. Epub 2021 Apr 26. Epub 2022 Feb 9. Though there's no single-known cause, it may be brought on by a drug interaction, or the reactivation of herpes simplex virus 6 or 7. F. Drago, G. Ciccarese, A. Parodi Accessibility 2021 Aug;35(8):e491-e493. Marzano AV, Cassano N, Genovese G, Moltrasio C, Vena GA. Cutaneous manifestations in patients with COVID19: a preliminary review of an emerging issue. doi: 10.1111/dth.13730. The appearance of pityriasis rosea following the first injection of the AstraZeneca vector vaccine suggests a causal connection. Although histopathologic characteristics of PR are also observed in PR-like lesions, the presence of dyskeratotic keratinocytes, interface dermatitis, and eosinophilic infiltration in the dermis may be more prominent in PR-like eruptions (11). Suchonwanit P, Leerunyakul K, Kositkuljorn C. Diagnostic and prognostic values of cutaneous manifestations in COVID-19. The patches may itch. 8600 Rockville Pike Recurrent and persistent pityriasis rosea: an atypical case presentation. They were found on hands and feet, showing up as red or purple spots caused by bleeding under the skin. Curr Dermatol Rep. 2022;11(4):289-312. doi: 10.1007/s13671-022-00370-9. Unauthorized use of these marks is strictly prohibited. Cutaneous Eruptions in the Course of COVID-19 Among Geriatric Patients in a Nursing Home in Poland. Drug-induced PR-like eruption accounts for 2% of all cutaneous adverse drug reactions (10). Lastly, Hartman says PR can present differently in patients with darker skin: "The characteristic erythematous plaques may appear more hyperpigmented or violaceous in darker skin types. 8600 Rockville Pike Some people who have had cosmetic fillers used to remove . The site is secure. Bookshelf SARS-CoV-2 spike protein positivity in pityriasis rosea-like and urticaria-like rashes of COVID-19. The .gov means its official. Pityriasis rosea (PR)-like eruption is a cutaneous complication associated with several medications and vaccinations. In some cases, central hyperpigmentation was identified. HHS Vulnerability Disclosure, Help (2021) 93:18501. -. 2023 Feb 9;11(2):397. doi: 10.3390/vaccines11020397. . It may appear on any part of your body, but it usually appears on the trunk (torso), arms and legs. We present two cases of COVID-19 vaccine-induced pityriasis rosea. Clipboard, Search History, and several other advanced features are temporarily unavailable. It was described as "clinically reminiscent" of pityriasis rosea by the authors, from the divisions of dermatology and venereology, pathology, intensive care, and the virology laboratory, of the Hpital Cochin, Paris. Vaccination is one of the cornerstones in the efforts towards ending the coronavirus disease 2019 (COVID-19) pandemic. Involvement of the oral mucosa has also been reported in as many as 50% of all cases (11). PMC If I dont have pityriasis rosea, what other skin condition might I have? Careers. 2021 May;62(2):e333-e334. Authors Lina Abdullah 1 The typical distribution of the rash is on the trunk between the neck and the knees.". J Eur Acad Dermatol Venereol 2020; 34: e436-e437. government site. Herald patch in the right hypochondrium followed by typical oval-shaped secondary plaques, Pityriasis rosea lesions on the upper extremities, MeSH These findings were consistent with a diagnosis of PR-like eruption. MeSH It could be pityriasis rosea here's how to treat it. PMC The ones found in people with pityriasis rosea are human herpesviruses 6 and 7. Parakeratosis with minimal acanthosis, MeSH New York City-based dermatologist Macrene Alexiades. Published by Elsevier Inc. Pityriasis rosea. FOIA doi: 10.1111/jdv.17316, PubMed Abstract | CrossRef Full Text | Google Scholar, 2. doi: 10.1111/ijd.15700, 4. Also, topical medication with dermatocorticosteroids and emollients was associated. It's also what's known as a self-limiting rash, Hartman says, in that it can resolve itself on its own without treatment in about six to eight weeks. JAAD Case Rep. (2018) 4:8001. 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. In conclusion, we have described the first case of PR-like eruption following ChAdOx1 nCoV-19 (Oxford/AstraZeneca) vaccination. An official website of the United States government. Would you like email updates of new search results? Clipboard, Search History, and several other advanced features are temporarily unavailable. Get useful, helpful and relevant health + wellness information. "And it has a particular [dermatomal] distribution because it's along a nerve," which also presents as fluid-filled blisters, rather than lesions. Considering the actual epidemiological context, we performed a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay from nasal and pharyngeal swabs for coronavirus disease 2019 (COVID-19) to investigate the PR etiology. Accessibility Anyone can get pityriasis rosea. You cant spread pityriasis rosea to another person through unprotected sex or skin-to-skin contact. ", The 29 Best Valentines Day Gifts for the Men in Your Life. However, if it does, the symptoms may last for a longer period. (2017) 9:7399. doi: 10.4081/dr.2017.7399, 17. -, Drago F, Ciccarese G, Javor S, Parodi A. Vaccineinduced pityriasis rosea and pityriasis rosealike eruptions: a review of the literature. Dermatol Ther. government site. 2021 Nov 2;17(11):4097-4098. doi: 10.1080/21645515.2021.1963173. Bethesda, MD 20894, Web Policies Most of the rare, severe allergic reactions to these vaccines have occurred in people with a history of allergies. McMahon DE, Amerson E, Rosenbach M, Lipoff JB, Moustafa D, Tyagi A, et al. MeSH Epub 2022 Jan 5. See your skin clear. At first, I thought it could be a fungal infection like ringworm, a common misdiagnosis, says Hartman, but my dermatologist ruled that out when I mentioned the additional spots erupting on my back via our video chat. 2022 Jul 21;14(7):e27108. From grooming sets to self-care gadgets, we've got them covered. doi: 10.1111/jdv.17301. doi: 10.1111/j.0022-202X.2005.23719.x. 2021;35(8):e489e491. NCI CPTC Antibody Characterization Program, Ritchie H., Mathieu E., Rodes-Guirao L., et al. Authors Jordan E Buckley 1 , Laura N Landis 2 , Ronald P Rapini 1 Affiliations 2021 Dec;108(6):317-318. doi: 10.12788/cutis.0411. PR is a common self-limited papulosquamous eruption typically presenting with a large solitary pink-colored patch or plaque (i.e., herald patch), followed by secondary eruptions of smaller erythematous patches or plaques with associated peripheral collarette scaling distributed along the cleavage lines of the trunk, forming a Christmas tree pattern (5). Epub 2022 Feb 9. doi: 10.1002/jmv.26549, 9. Birlutiu V, Dobritoiu ES, Lupu CD, Herteliu C, Birlutiu RM, Dragomirescu D, Vorovenci A. National Library of Medicine 18. These patches are smaller than the herald patch they range from 1 to 2 cm and are often called daughter patches. See this image and copyright information in PMC. NCI CPTC Antibody Characterization Program. 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). Human herpesvirus6, 7, and EpsteinBarr virus reactivation in pityriasis rosea during COVID19. Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Clin Cosmet Investig Dermatol. and transmitted securely. Accessibility Here, we described a case of PR-like eruption that developed 14 days after Oxford/AstraZeneca vaccination in a 52-year-old Thai woman with glioblastoma. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. FOIA Bathe or shower in lukewarm water. Accessibility KL and KP collated resources. For instance, the rash sometimes appears only under the arms or on the flanks. HHS Vulnerability Disclosure, Help Please enable it to take advantage of the complete set of features! 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 vaccine. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination: A systematic review and meta-analysis. Epub 2022 May 3. Among patients who received inactivated vaccines, another case of PR-like eruption was reported four days after the first dose of CoronaVac (SinoVac) (1). (2020) 33:e13650. 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).
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