Abstract and Introduction
Abstract
Background: As many people worldwide have been vaccinated, more triggered autoimmune bullous diseases have been noticed. We reported a case of new-onset pemphigus Vulgaris after COVID-19 vaccinations.
Case Presentation: A 50 years old Syrian female presented with multiple erosions on her extremities, in addition to oral erosions and genital ulcers, after the 2nd dose of the mRNA COVID-19 vaccine. The lesions were multiple tenders and well-defined, reddish erythematous oral ulcers. At the same time the Skin examination showed hyper-pigmented patches over the extremities, a sequel of ruptured bullae. Pemphigus Vulgaris was diagnosed by histology. She continued on 35 mg/day of prednisone for another 2 weeks.
Conclusions: Pemphigus is not a contraindication to vaccination, although it may be worse or present as a first onset.
Introduction
Pemphigus Vulgaris is a rare, fatal, autoimmune disease. It occurred due to the disruption of intercellular keratinocytes junctions by anti-desmoglein antibodies.[1]
It is usually affecting middle-aged patients. It causes mucous membranes and cutaneous blisters. It may be triggered or aggravated by some treatment or vaccines like hepatitis B, influenza, rabies, and tetanus vaccination.[1]
About half of the patients have only oral erosions, which often precede skin involvement. Dysphagia is common due to esophagus involvement. In addition, the Cutaneous bullae leave a raw area with crusting. The Erosions often become infected. Fluid and electrolyte loss may happen when large body areas are affected. This disorder must be differentiated from other conditions that cause chronic oral ulcers and skin bullous.[2]
The diagnosis is confirmed by lesional and surrounding normal skin biopsy that shows IgG autoantibodies binding the keratinocyte's cell surface by immunofluorescence. Desmoglein 1 and desmoglein three transmembrane glycoproteins autoantibodies can be found.[2]
Vaccines are still the most effective and protective method against COVID-19 infection. However, there are cases of new onset or flare of pemphigus following COVID-19 vaccination.[3]
We are reporting A triggered bullous lesion after the second vaccine dose.
J Med Case Reports. 2023;17(322) © 2023 BioMed Central, Ltd.
