engleski

A rare case of bullous Sweet syndrome after Covid-19 vaccination

Concurrent to the increasing use of COVID-19 vaccines, the number of vaccine-related cutaneous and extracutaneous adverse reactions has also increased. Local injection-site reactions are the most reported adverse effects described with the use of these vaccines. A bullous variant of Sweet syndrome (SS) is a rare form of SS, which clinically presents as bullous hemorrhagic rash and demonstrates dermal neutrophilic infiltrates with segregation of dermo-epidermal junction. Only a few cases of SS induced by any vaccine were reported in the literature to our best knowledge. We report a case of a 49-year-old male patient who presented with generalized painful cutaneous eruption. He denied any preceding respiratory or gastrointestinal symptoms or introduction of any medications. However, 10 days before the rash onset, he received the first dose of the SARS- CoV-2 Oxford-AstraZeneca vaccine. Upon physical examination, we observed symmetrically distributed erythematous to violaceous vesicular papules and targetoid plaques on the lower part of the trunk and extremities, along with multiple grouped hemorrhagic blisters on both hands and feet. The patient was subfebrile and reported mild arthralgia, no other extracutaneous symptoms were present. Initial laboratory investigation revealed leukocytosis with neutrophilia, while C-reactive protein, liver, renal function tests, urine analysis were all within the reference range. The SARS-CoV-2 RT-PCR test was negative. IgG SARS-CoV-2 antibodies were positive (895.3 AU/ml). Serology tests for viral and bacterial agents were all negative. Chest X-ray and abdominal ultrasound were unremarkable. Histopathological findings were consistent with Sweet syndrome (SS). Balancing the possible link between vaccination and SS, we decided to contraindicate the second dose of vaccine. Because of the ongoing pandemic and introduction of new vaccines, it is of great importance that all potential side effects are reported and considered.

adverse reaction ; Sweet syndrome ; COVID-19 vaccine

nije evidentirano