Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. Adverse cutaneous reactions following COVID-19 vaccines have increased, highlighting not only how SARS-CoV-2 infection but also COVID-19 vaccines may induce adverse cutaneous manifestations. Br J Dermatol. Pityriasis rosea, COVID-19 and vaccination: new keys to understand an old acquaintance. 2022 Nov;36(11):1947-1968. doi: 10.1111/jdv.18294. 2022 Nov 6;15:2369-2382. doi: 10.2147/CCID.S388245. A more recent letter in the International Journal of Dermatology reported a "unique case of pityriasis rosea following administration of mRNA COVID-19 vaccine." | Pityriasis Rosea, COVID-19 and . 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. 2022 Mar 15;10(3):624. doi: 10.3390/microorganisms10030624. Proc (Bayl Univ Med Cent). Nevertheless, she did not present with fever or respiratory tract symptoms. Epub 2022 Jun 21. 2021;35(9):e546e548. Bethesda, MD 20894, Web Policies Develop a large patch on your skin. doi: 10.1111/ijd.15700, 4. Laboratory investigation results (i.e., complete blood count, blood chemistry, C-reactive protein level, erythrocyte sedimentation rate, serological test for syphilis, plasma polymerase chain reaction (PCR) for human herpesvirus (HHV)-6 and HHV-7, and reverse transcription-PCR for COVID-19) were unremarkable. 2022 Nov 6;15:2369-2382. doi: 10.2147/CCID.S388245. Disseminated erythematous-papulosquamous lesions, with right laterocervical herald patch (clinical aspect on admission). Epub 2022 Feb 9. 8 PDF Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases D. McMahon, E. Amerson, +11 authors E. Freeman Medicine JAAD Int. A 3-cm oval plaque with peripheral scale, larger than the other lesions, was present on the inferior portion of the right breast. Before Federal government websites often end in .gov or .mil. doi: 10.7759/cureus.22414. Its important to pay attention to your skin. Epub 2021 Apr 26. 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. Please enable it to take advantage of the complete set of features! 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. The authors have no conflicts of interests to disclose. Most people with the rash are 10 to 35 years of age. J Med Virol 2021; 93: 1850-1851. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination: A systematic review and meta-analysis. For instance, the rash sometimes appears only under the arms or on the flanks. Table 1 summarizes all reported cases of PR-like eruption following COVID-19 vaccination. Pityriasis Rosea-like eruptions following COVID-19 mRNA-1273 vaccination: A case report and literature review. Also, topical medication with dermatocorticosteroids and emollients was associated. COVID-19 vaccines reactions, type I hypersensitivity reactions (such as urticaria, angioedema, and anaphylaxis), . The typical distribution of the rash is on the trunk between the neck and the knees.". If you have pityriasis rosea, its unlikely that youll get it again. Epub 2022 Jan 31. Accessibility 2022 Jul 8;101(27):e29823. Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. Front. How long will it take my body to clear the rash? Careers. ", Though there's no single-known cause, King says, "pityriasis rosea is associated with reactivation of herpesviruses 6 and 7 [HHV-6 and HHV-7, respectively], which cause the primary rash, roseola, in infants. Those ensuing spots like the circle of dots that erupted on my back a day after the initial raised welt appeared typically resemble a Christmas tree-like formation. "However, it's possible to develop the rash more than once," she says. Medicine (Baltimore). Pityriasis rosea-like eruptions following vaccination with BNT162b2 mRNA COVID-19 Vaccine. Coronavirus pandemic (COVID-19), McMahon D.E., Amerson E., Rosenbach M., et al. Cebeci Kahraman F, Sava Erdoan S, Akta ND, Albayrak H, Trkmen D, Borlu M, Arca DA, Demirba A, Akbayrak A, Polat Ekinci A, Gkek GE, elik HA, Taolar MK, An , Temiz SA, Hazinedar E, Ayhan E, Hzl P, Solak E, Kl A, Ylmaz E. J Cosmet Dermatol. This reaction is self-limited and resolves in an average of 5.6 weeks. -, Neoh CY, Tan AW, Mohamed K, et al. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article. Disseminated erythematous-papulosquamous lesions, with right. Interventions: 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). The patient developed papulovesicular lesions in the crease lines of the trunk and extremities, four days after inoculation with a recombinant coronavirus vaccine (Covishield, India). Would you like email updates of new search results? Among the common cutaneous manifestations of COVID-19 (e.g., morbilliform eruptions, chilblains, and varicella-like vesicles), PR and PR-like eruptions have rarely been described (6, 7). Apply a moisturizer, calamine lotion or a nonprescription . Unable to load your collection due to an error, Unable to load your delegates due to an error. HHS Vulnerability Disclosure, Help Epub 2021 Nov 2. 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). 2021;35(8):e489e491. Shingles was another fear, as I had chicken pox when I was four, but we ruled that out too: "Shingles is a nerve-mediated process; it tends to be very painful, not so itchy," Lam says. Pityriasis rosea (PR) is an acute papulosquamous cutaneous disorder that classically presents with a herald patch rapidly followed by a widespread rash along skin cleavage lines. Epub 2022 Jan 5. Copyright 2021 the Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Epub 2022 Jun 8. Alamri A, Alghamdi Y, Alamri SJ, Althaqafi MK, AlQurashi W, Bader BA, Mohanna AT, Almahdi B. Cureus. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Bookshelf doi: 10.1111/jdv.17342. We present two cases of COVID-19 vaccine-induced pityriasis rosea. The site is secure. Pityriasis rosea commonly affects the skin on your trunk, arms or legs. Yes, There Is a Correct Order for Everything You Do in the Shower, Each Zodiac Sign's Unique Personality Traits, Swoopy 1960s Hair Was Everywhere at the SAG Awards, Christina Aguilera Opened Up About Getting Injections and Why She Doesn't Care If People Judge Her, "I think we all can rely on a little help. The https:// ensures that you are connecting to the (2021) 60:11501. Few scattered dyskeratotic keratinocytes are seen in the lower epidermis. Some studies have identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike proteins on endothelial cells and lymphocytes from PR-like lesions, consistent with direct viral invasion (3, 4). 2022 Feb 20;14(2):e22414. See this image and copyright information in PMC. (2016) 55:e33843. A case of Pityriasis rosea is presented in a 66-year-old black male 1 week after administration of the Pfizer-BioNTech COVID-19 vaccine. 18. [Epub ahead of print]. 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. Advertising on our site helps support our mission. 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. Hum Vaccin Immunother. National Library of Medicine 2022 Aug 11;9(8):43. doi: 10.3390/medicines9080043. Here, we describe a case of PR-like eruption following ChAdOx1 nCoV-19 (AZD1222) vaccination in a Thai patient with glioblastoma. 8 In some cases, antibodies against HHV6/7 as well as viral DNA in plasma and PBMCs were detected. 8600 Rockville Pike These strains of the herpes virus arent related to the strains that cause cold sores or genital herpes. Drago F, Ciccarese G, Javor S, et al. Akdas E, Ilter N, Ogut B, Erdem O. Pityriasis rosea following CoronaVac COVID-19 vaccination: a case report. Leerunyakul K, Pakornphadungsit K, Suchonwanit P. Front Med (Lausanne). KL and KP collated resources. (2017) 5:20311. The significance of investigating clinical, histopathologic and virological features in pityriasis rosea and pityriasis rosea-like eruptions following COVID-19 vaccinations. Pityriasis rosea-like Covid-arm Erythema multiforme Erythroderma Psoriasis Others Grover-like eruptions Herpes simplex reactivation: 24 1 17 4 2 2 1 1 20 15 9 5 2 1 1 1 3 3: 21.5 0.9 15 3.5 1.8 1.8 0.9 0.9 . Fortunately, PR-like eruption is responsive to topical corticosteroids without any systemic adverse effects. 2022 Oct;49(10):948-956. doi: 10.1111/1346-8138.16482. However, if it does, the symptoms may last for a longer period. Ad Choices. Bookshelf doi: 10.1111/bjd.20143. ", The 29 Best Valentines Day Gifts for the Men in Your Life. Pityriasis rosea-like eruption revealing COVID-19. (2006) 12:1. doi: 10.5070/D380D8301D, 11. Pityriasis rosea as a cutaneous manifestation of COVID-19 infection Pityriasis rosea as a cutaneous manifestation of COVID-19 infection Pityriasis rosea as a cutaneous manifestation of COVID-19 infection Pityriasis rosea as a cutaneous manifestation of COVID-19 infection J Eur Acad Dermatol Venereol. official website and that any information you provide is encrypted This tiny glimpse of her natural texture is thrilling. Epub 2021 May 29. (2021) 35:e5468. Moreover, while dermoscopy may facilitate the diagnosis of PR, its utility for atypical PR or PR-like lesions is still limited. Pityriasis rosea and ringworm look similar. FOIA The .gov means its official. Children often get infected when someone sneezes or kisses them. Federal government websites often end in .gov or .mil. Recurrent and persistent pityriasis rosea: an atypical case presentation. Cutaneous Eruptions in the Course of COVID-19 Among Geriatric Patients in a Nursing Home in Poland. Accessibility Br J Dermatol. Sprinkle bath water with an oatmeal-based bath product (Aveeno). Accessibility Figure 2. (a) Pityriasis rosea (chest, flank, and axilla); (b) pityriasis rosea (back). FOIA Some rare cases can take up to three months. Vaccination is one of the cornerstones in the efforts towards ending the coronavirus disease 2019 (COVID-19) pandemic. A virus may cause pityriasis rosea, but experts arent sure. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2022 Aug;20(8):1123-1124. doi: 10.1111/ddg.14784. Unable to load your collection due to an error, Unable to load your delegates due to an error. eCollection 2022. They indicate that eight types of rash could be signs of Covid-19, including red toes and fingers, chest eczema and pityriasis rosea (scroll down for the full list). doi: 10.1111/jdv.17342. Birlutiu V, Dobritoiu ES, Lupu CD, Herteliu C, Birlutiu RM, Dragomirescu D, Vorovenci A. Central dusky-red erythematous on some plaques (A); almost all lesions fading with associated post-inflammatory hyperpigmentation after treatment (B). Human herpesviruses 6 and 7 are common. Epub 2020 Jun 29. A variant called inverse pityriasis rosea can affect the skin on your neck, face, armpits (axillae) and groin, though it isnt common. Table 1. Clin Dermatol. Marcantonio-Santa Cruz OY, Vidal-Navarro A, Pesqu D, Gimnez-Arnau AM, Pujol RM, Martin-Ezquerra G. J Eur Acad Dermatol Venereol. The evolution was unfavorable, with the spread of the lesions and the accentuation of the pruritus. Authors Jordan E Buckley 1 , Laura N Landis 2 , Ronald P Rapini 1 Affiliations Figure 3. 9 , 10 These findings suggest that immuneinduced viral reactivation - rather than 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). 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. Khalili M, Abtahi-Naeini B, Rastegarnasab F, Afshar K. Clin Case Rep. 2022 Jul 19;10(7):e6096. Had I started new medication? HHS Vulnerability Disclosure, Help (Unfortunately, I scratched my rash until it bled, so my hyperpigmentation may linger.). government site. eCollection 2022. The https:// ensures that you are connecting to the In conclusion, we have described the first case of PR-like eruption following ChAdOx1 nCoV-19 (Oxford/AstraZeneca) vaccination. Healthcare experts believe herpesvirus 6 (HHV-6), HHV-7 and/or HHV-8 cause pityriasis rosea, but there arent any conclusive studies. It is usually seen in children, adolescents, and young adults. Careers. In approximately 50% of people with pityriasis rosea, the patches itch. and transmitted securely. Of the reported cases, 96.7% were secondary to the Pfizer vaccine, with only 1 reported . FOIA Epub 2022 May 3. Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review. Clinical findings of pityriasis rosealike eruption in the patients. Pityriasis Rosea Associated With COVID-19 Vaccination: A Common Rash Following Administration of a Novel Vaccine. You cant spread pityriasis rosea to another person through unprotected sex or skin-to-skin contact. NCI CPTC Antibody Characterization Program, Ehsani AH, Nasimi M, Bigdelo Z. Pytiriasis rosea as a cutaneous manifestation of COVID-19 infection. To the best of our knowledge, there have been no reports of PR-like eruptions following inoculation with Oxford/AstraZeneca ChAdOx1 nCoV-19 (AZD1222) vaccine. Coronavirus disease 2019 and pityriasis rosea: A review of the immunological connection. In addition to COVID-19 vaccination, she was currently taking medications (i.e., levetiracetam and thyroxin) for glioblastoma, and the two drugs had been prescribed for approximately nine months. Refined carbohydrates, such as sugar, pastries and white bread. Would you like email updates of new search results? While you don't need to treat the rash, some patients ask for treatment to take care of the following. Pityriasis rosea isnt a sexually transmitted disease or infection (STD or STI). -, Carballido Vzquez A.M., Morgado B. Pityriasis rosea-like eruption after Pfizer-BioNTech COVID-19 vaccination. In my experience, patients with darker skin are more likely to present with atypical forms of the disorder. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291919/). Pityriasis rosea, pityriasis rosea-like eruptions, and herpes zoster in the setting of COVID-19 and COVID-19 vaccination. J Am Acad Dermatol. Under the treatment that was initiated a partial remission of the lesions after 7 days was observed. 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. 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. Please enable it to take advantage of the complete set of features! eCollection 2021. It is likely that a new viral trigger of pityriasis rosea is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 2022 May;121(5):1003-1007. doi: 10.1016/j.jfma.2021.12.028. 8600 Rockville Pike Pityriasis rosea following SARS-CoV-2 vaccination: A case series. Polack FP, Thomas SJ, Kitchin N, et al. Pityriasis rosea: An update on etiopathogenesis and management of difficult aspects. Herzum A, Trave I, D'Agostino F, Burlando M, Cozzani E, Parodi A. Clin Exp Vaccine Res. The clinics of HHV-6 infection in COVID-19 pandemic: Pityriasis rosea and Kawasaki disease. Pityriasis rosea (PR)-like eruption is a rare cutaneous complication of immunization. Your California Privacy Rights. An official website of the United States government. While annoyingly itchy, the rash does not cause any serious long-term side effects and is not contagious, unlike the diseases these vaccines protect against. HHS Vulnerability Disclosure, Help The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). However, the studies dont conclusively prove that COVID-19 causes pityriasis rosea. Epub 2022 Jun 26. Your rash looks infected (red, purple, gray or white skin; irritation and swelling). The symptoms of pityriasis rosea usually develop in stages: Pityriasis rosea doesnt hurt. Pityriasis rosea and pityriasis rosea-like eruptions after COVID-19 vaccines. doi: 10.1111/dth.13878, 10. The Covid Symptom Study. Before The .gov means its official. Keywords: PMC An official website of the United States government. Clinical manifestations and histopathologic findings of reported patients with pityriasis-rosea like eruptions following COVID-19 vaccination. (2017) 9:7399. doi: 10.4081/dr.2017.7399, 17. -, Broccolo F., Drago F., Careddu A.M., et al. official website and that any information you provide is encrypted Clinical findings of pityriasis rosealike, Clinical findings of pityriasis rosealike eruption in the patients. Epub 2021 Aug 26. Clipboard, Search History, and several other advanced features are temporarily unavailable. Pityriasis Rosea as a Possible Complication of Vaccination Against COVID-19. official website and that any information you provide is encrypted Get useful, helpful and relevant health + wellness information. However, if you experience any symptoms, therapy can provide relief. The site is secure. Flares of other types of skin conditions [like psoriasis] sometimes have been described as well," says Lam. Some people who have had cosmetic fillers used to remove . Theyre both papulosquoamous (pap-you-lo-skway-miss) disorders, which is a term used to characterize skin disorders according to the presence of raised, discolored, scaly patches of skin. Bethesda, MD 20894, Web Policies An official website of the United States government. 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. Unauthorized use of these marks is strictly prohibited. doi: 10.1111/dth.13730. The patches may itch. Epub 2022 Jun 21. Unauthorized use of these marks is strictly prohibited. The papillary dermis shows melanin incontinence, perivascular lymphocytic infiltrate and rare scattered extravasated red blood cells. They were found on hands and feet, showing up as red or purple spots caused by bleeding under the skin. 2022 Oct;123:58-69. doi: 10.1016/j.ijid.2022.06.037. Drug-induced PR-like eruption accounts for 2% of all cutaneous adverse drug reactions (10). 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. You may initially develop a fever, headache or upper respiratory infection. 8600 Rockville Pike (2021). . In some cases, central hyperpigmentation was identified. doi: 10.1111/dth.15601. Another skin condition identified in the study were "vesicular eruptions" seen in 9 per cent of cases. The site is secure. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. -, Cyrenne BM, Al-Mohammedi F, DeKoven JG, Alhusayen R. Pityriasis rosea-like eruptions following vaccination with BNT162b2 mRNA COVID-19 vaccine. Authors B M Cyrenne 1 , F Al-Mohammedi 1 , J G DeKoven 1 , R Alhusayen 1 Affiliation Pityriasis Rosea Shortly After mRNA-1273 COVID-19 Vaccination. sharing sensitive information, make sure youre on a federal In darker-skinned or Black people, the patches may be more raised (papular), and the centers of the patches may look like the tissue is dying (necrotic). Would you like email updates of new search results? See this image and copyright information in PMC. Studies show that the development of pityriasis rosea during pregnancy may cause birth complications, including miscarriage and poor muscle tone and development once the baby is born (neonatal hypotonia). 2022 Mar 9;35(3):342-343. doi: 10.1080/08998280.2022.2044742. Dermatol Online J. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). official website and that any information you provide is encrypted Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Ciccarese G, Parodi A, Drago F. SARS-CoV-2 as possible inducer of viral reactivations. 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. Treatment with topical 0.1% triamcinolone acetonide twice per day showed partial response after seven days. Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Clin Cosmet Investig Dermatol. Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature. and transmitted securely. (b) Patient 1: Closeup of a plaque. Pityriasis rosea (PR)-like eruption is a cutaneous complication associated with several medications and vaccinations. doi: 10.1097/MD.0000000000029823. Although the exact pathogenesis of PR is unknown, current evidence suggests that an inflammatory reaction due to a viral trigger may lead to the cutaneous manifestations. Pearls and pitfalls: Adverse cutaneous reactions after COVID-19 vaccination. For most people, it resolves without treatment. (No.) The authors have no conflicts of interest to declare. COVID-19-associated pityriasis rosea in children: Case report and literature review. eCollection 2022 Feb. Kroumpouzos G, Paroikaki ME, Yumeen S, Bhargava S, Mylonakis E. Microorganisms. I video-chatted with my dermatologist who asked a few questions: Did I have body aches or flu-like symptoms? Numerous scattered erythematous plaques with fine scale oriented along skin cleavage lines, most appreciable on the upper portion of the chest. Dermatol Ther. Federal government websites often end in .gov or .mil. (2021) 85:4655. Vaccinations have been identified to rarely cause several cutaneous reactions. You may be at risk of developing an allergic reaction on your skin. 2022 Nov;36(11):1947-1968. doi: 10.1111/jdv.18294. government site. Pityriasis rosea-like eruptions following vaccination with BNT162b2 mRNA COVID-19 Vaccine J Eur Acad Dermatol Venereol. (d) Patient 2: Closeup of plaques, with the hyperpigmented centre and trailing scale. JAAD Case Rep. 2021;7:9394. Dermatol Reports. (a) Patient 1: Thin, Histopathological findings of pityriasis rosealike, Histopathological findings of pityriasis rosealike eruption in patient 1. Pityriasis rosea-like rash after messenger RNA COVID-19 vaccination: A case report and review of the literature. 2022 Sep;21(9):3692-3703. doi: 10.1111/jocd.15209. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: a registry-based study of 414 cases. eCollection 2022 Jul. Clipboard, Search History, and several other advanced features are temporarily unavailable. Federal government websites often end in .gov or .mil. Eczema, Psoriasis, Cutaneous Infections, Acne, and Other Common Skin Disorders. doi: 10.1111/jdv.17301. Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature.