A clinical case of a patient with mucocutaneous and musculoskeletal manifestations after COVID-19 vaccination
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Keywords

COVID-19, SARS-CoV-2, vaccination, adverse events, alopecia areata

How to Cite

Dimova, Z., Boyadzhieva, V., Stoilov, N., Emin, S., Nikolov, N., & Stoilov, R. (2022). A clinical case of a patient with mucocutaneous and musculoskeletal manifestations after COVID-19 vaccination. Rheumatology (Bulgaria), 30(2), 102-107. https://doi.org/10.35465/30.2.2022.pp102-107

Abstract

With the onset of the global pandemic due to the new virus SARS-CoV-2 and the development of vaccines against it, various adverse events have been reported to them. We present a clinical case of a 53-year-old Caucasian woman who presented one week after Pfizer vaccination against SARS-CoV-2 with severe muscle weakness, myalgia in upper and lower extremities, alopecia 2 cm in diameter, and two mucosal ulcerations on lower lip. No deviations from the hematological, biochemical and immunological indicators were found from the laboratory tests carried out. Two weeks later, the patient developed total alopecia on the scalp. Due to the causal relationship with the administered vaccine, the patient was not given a second dose and a diagnosis of Systemic Connective Tissue Disease was not accepted. Six months later, recovery and partial hair growth was observed in the affected areas of the capillitium.

Alopecia areata is autoimmune in nature, with literature reporting initial or recurrent alopecia after vaccination. It is important that adverse events after vaccination are properly evaluated in order to choose a proper therapeutic approach.

https://doi.org/10.35465/30.2.2022.pp102-107
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References

  1. Stoilov, N. and Boyadzhieva, V. 2021. SARS-CoV-2 and autoimmune rheumatic diseases. Rheumatology (Bulgaria). 28, 4 (Feb. 2021), 36-44
  2. S.H. Hodgson, K. Mansatta, G. Mallett, V. Harris, K.R.W. Emary, A.J. Pollard What defines an efficacious COVID-19 vaccine? A review of the challenges assessing the clinical efficacy of vaccines against SARS-CoV-2; Lancet Infect. Dis. (2020), 10.1016/s1473-3099(20)30773-8
  3. As of 11 April 2022 https://covid19.who.int/
  4. https://www.cdc.gov/smallpox/history/history.html
  5. Gambichler, T., Boms, S., Susok, L., Dickel, H., Finis, C., Abu Rached, N., Barras, M., Stücker, M. and Kasakovski, D. (2022), Cutaneous findings following COVID-19 vaccination: review of world literature and own experience. J Eur Acad Dermatol Venereol, 36: 172-180.
  6. Saoji V, Kulkarni S, Madke B. Alopecia areata treated with oral azathioprine: a case series. International Journal of Trichology. 2019 Sep;11(5):219.
  7. Galeotti, Caroline, and Jagadeesh Bayry. “Autoimmune and inflammatory diseases following COVID-19.” Nature reviews. Rheumatology vol. 16,8 (2020): 413-414.
  8. FIvenson, David. “COVID-19: association with rapidly progressive forms of alopecia areata.” International journal of dermatology vol. 60,1 (2021): 127.
  9. Català, A et al. “Cutaneous reactions after SARS-CoV-2 vaccination: a cross-sectional Spanish nationwide study of 405 cases.” The British journal of dermatology vol. 186,1 (2022): 142-152.
  10. Wise RP, Kiminyo KP, Salive ME. Hair loss after routine immunizations. JAMA. 1997;278:1176–1178
  11. Sanchez-Ramon S, Gil J, Cianchetta-Sivori M, Fernandez-Cruz E. Alopecia universalis in an adult after routine tetanus toxoid vaccine. Med Clin (Barc) 2011;136:318.
  12. Essam, Reham et al. “Alopecia areata after ChAdOx1 nCoV-19 vaccine (Oxford/AstraZeneca): a potential triggering factor?.” Journal of cosmetic dermatology vol. 20,12 (2021): 3727-3729.
  13. Gallo G., Mastorino L. et al. “Alopecia areata after COVID-19 vaccination” Korean vaccine society vol: 129-132
  14. Scollan ME, Breneman A, Kinariwalla N, Soliman Y, Youssef S, Bordone LA, Gallitano SM. Alopecia areata after SARS-CoV-2 vaccination. JAAD Case Rep. 2022 Feb;20:1-5.
  15. Rossi A, Magri F, Michelini S, Caro G, Di Fraia M, Fortuna MC, Pellacani G, Carlesimo M. Recurrence of alopecia areata after covid-19 vaccination: A report of three cases in Italy. J Cosmet Dermatol. 2021 Dec;20(12):3753-3757.
  16. MacLean KJ, Tidman MJ. Alopecia areata: more than skin deep. Practitioner. 2013 Sep;257(1764):29-32, 3.
  17. United States Department of Health and Human Services (DHHS) Public Health Service (PHS) Centers for Disease Control (CDC)/Food and Drug Administration (FDA) The Vaccine Adverse Event Reporting System (VAERS) 1990 - 11/05/2021, CDC WONDER online database. http://wonder.cdc.gov/vaers.html
  18. Scollan ME, Breneman A, Kinariwalla N, Soliman Y, Youssef S, Bordone LA, Gallitano SM. Alopecia areata after SARS-CoV-2 vaccination. JAAD Case Rep. 2022 Feb;20:1-5. doi: 10.1016/j.jdcr.2021.11.023.
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