key: cord-0766729-m88j9g9a
authors: Fernández, Lucía T.; Pérez‐Garza, Daniela M.; delaO‐Escamilla, Alejandra; Yamallel‐Ortega, Luis A.; Cuellar‐Barboza, Adrian; Ocampo‐Candiani, Jorge; Chavez‐Alvarez, Sonia
title: Pityriasis rubra pilaris in association with inactivated SARS‐CoV‐2 vaccine (CoronaVac)
date: 2022-03-28
journal: Dermatol Ther
DOI: 10.1111/dth.15455
sha: 354387a9d3c8755671c80ea729b93abf5a9e4d19
doc_id: 766729
cord_uid: m88j9g9a

nan

Dear Editor, Cutaneous reactions associated with CoronaVac vaccine have been registered in 11.3% of the patients. The most frequent reported reaction is urticaria, followed by exacerbation of chronic atopic diathesis and papulosquamous/pityriasiform lesions. Most of reactions improved within few weeks of onset without treatment. 1 However, there are no reports of the inactivated vaccine as a trigger of pityriasis rubra pilaris (PRP).

A 59-year-old otherwise healthy man presented with a 2-month history of a mildly pruritic widespread erythematous scaly rash that started 4 days after the CoronaVac second dose. Lesions started on the face, neck, and trunk; then spread to upper and lower limbs. He denied prior SARS-CoV-2 infection or any adverse reaction following the first dose.

Physical examination revealed widespread follicular-based erythematous hyperkeratotic papules coalescing into large orange-red scaly patches and plaques surrounded by islands of spared skin ( Figure 1A ,B); orangered waxy palmoplantar keratoderma ( Figure 1E ), diffuse fine scale on the scalp, and malleolar edema. HIV test was negative. Skin biopsy was consistent with PRP. He was treated with high-potency topical corticosteroids (TC) with partial improvement.

A 56-year-old man with a history of vitiligo and diabetes presented with a widespread erythematous scaly rash of 1-month duration. The rash had started on the lower limbs and disseminated to the thighs, (Table 1) .

Other vaccines known to precipitate PRP are diphtheria-pertussistetanus, measles-mumps-rubella, oral poliovirus, and influenza vaccines. 8 Although causality may not be demonstrated by these case reports, development of the lesions was temporally associated with vaccination. These cases evidence a potential side effect related to 

The patients in this manuscript have given written informed consent to publication of their case details.

All authors declare no conflicts of interest. 

The data that support the findings of this study are available from the corresponding author upon reasonable request 

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