The first reported case of erythrodermic sarcoidosis with systemic involvement during COVID-19 vaccination
https://doi.org/10.4081/dr.2023.9636
Accepted: 26 January 2023
HTML: 53
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. 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.
Post-vaccinal and parainfectious activation of the immunity with subsequent development of a certain immunological/skinimmunological disease is not rare in clinical practice. This concept is mentioned in relation to molecular/antigenic mimicry. To this day, the pathogenesis of sarcoidosis and sarcoid-type reactions remains a mystery. Moreover, they can be a warning sign of changes in tissue homeostasis, whether they are infectious, noninfectious- immunological, tumor-related, etc. We present a rare form of erythrodermic sarcoidosis with massive systemic involvement (pericarditis, supraventricular tachycardia, hepatitis, iritis/iridocyclitis, pulmonary fibrosis/bihilar lymphadenopathy, and arthritis) developed after receiving the ChadOx1-S vaccine for COVID- 19. Systemic immunosuppressive therapy with Methylprednisolone was introduced according to a scheme (in a reduction mode with an initial dose of 40 mg/day intravenously) in combination with topical Pimecrolimus 1% cream twice a day. Rapid improvement of the symptoms was observed within the first two days of treatment. According to the scientific literature, the presented patient turns out to be the first case of erythrodermic sarcoidosis (with systemic involvement), described as a side effect after vaccination and/or administration of a certain medicinal form.
Tchernev G, Tana C, Schiavone C, Cardoso JC, Ananiev J, Wollina U. Sarcoidosis vs. Sarcoid-like reactions: The Two Sides of the same Coin? Wien Med Wochenschr. 2014 Jul;164(13-14):247-59. doi: 10.1007/s10354-014-0269-x. Epub 2014 Mar 25. PMID: 24664574. DOI: https://doi.org/10.1007/s10354-014-0269-x
Tchernev G, Lotti T, Cardoso JC, Kanazawa N, Guarneri C, Wollina U. Cancer, infection and disturbances of the integrity of tissue homeostasis: the most significant triggers for molecular mimicry and autoimmunity in dermatology? Wien Med Wochenschr. 2014 Jul;164(13-14):245-6. doi: 10.1007/s10354-014-0280-2. PMID: 24796584. DOI: https://doi.org/10.1007/s10354-014-0280-2
Tchernev G, Ananiev J, Cardoso JC, Wollina U, Verma SB, Patterson JW, Dourmishev LA, Tronnier M, Okamoto H, Mizuno K, Kanazawa N, Gulubova M, Manolova I, Salaro C. Sarcoidosis and molecular mimicry--important etiopathogenetic aspects: current state and future directions. Wien Klin Wochenschr. 2012 Apr;124(7-8):227-38. doi: 10.1007/s00508-012-0154-9. Epub 2012 Apr 14. PMID: 22527817. DOI: https://doi.org/10.1007/s00508-012-0154-9
Rodrigues FT, Quirino RM, Gripp AC. Cutaneous and pulmonary manifestations of sarcoidosis triggered by coronavirus disease 2019 infection. Rev Soc Bras Med Trop. 2022 Apr 8;55:e06472021. doi: 10.1590/0037-8682-0647-2021. PMID: 35416881; PMCID: PMC9009884. DOI: https://doi.org/10.1590/0037-8682-0647-2021
Capaccione KM, McGroder C, Garcia CK, Fedyna S, Saqi A, Salvatore MM. COVID-19-induced pulmonary sarcoid: A case report and review of the literature. Clin Imaging. 2022 Mar;83:152-158. doi: 10.1016/j.clinimag.2021.12.021. Epub 2022 Jan 13. PMID: 35051738; PMCID: PMC8755635. DOI: https://doi.org/10.1016/j.clinimag.2021.12.021
Numakura T, Murakami K, Tamada T, Yamaguchi C, Inoue C, Ohkouchi S, Tode N, Sano H, Aizawa H, Sato K, Mitsune A, Kurosawa H, Nakazawa T, Sugiura H. A Novel Development of Sarcoidosis Following COVID-19 Vaccination and a Literature Review. Intern Med. 2022 Oct 15;61(20):3101-3106. doi: 10.2169/internalmedicine.0104-22. Epub 2022 Aug 10. PMID: 35945009. DOI: https://doi.org/10.2169/internalmedicine.0104-22
Manci R, Jennings T, Mclarney RM, Heymann WR, Sommer LL. An acute, ulcerative, sarcoidal tattoo reaction following SARS-CoV-2 mRNA-1273 vaccination. Dermatol Online J. 2021 Dec 15;27(12). doi: 10.5070/D3271256710. PMID: 35499440. DOI: https://doi.org/10.5070/D3271256710
Chahed F, Ben Fadhel N, Ben Romdhane H, Youssef M, Ben Hammouda S, Chaabane A, Aouam K, Ben Fredj N. Erythema nodosum induced by Covid-19 Pfizer-BioNTech mRNA vaccine: A case report and brief literature review. Br J Clin Pharmacol. 2022 Apr 17:10.1111/bcp.15351. doi: 10.1111/bcp.15351. Epub ahead of print. PMID: 35434826; PMCID: PMC9111509. DOI: https://doi.org/10.22541/au.164200658.86172959/v1
Matsuo T, Honda H, Tanaka T, Uraguchi K, Kawahara M, Hagiya H. COVID-19 mRNA Vaccine-Associated Uveitis Leading to Diagnosis of Sarcoidosis: Case Report and Review of Literature. J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096221086450. doi: 10.1177/23247096221086450. PMID: 35313760; PMCID: PMC8943455. DOI: https://doi.org/10.1177/23247096221086450
Rademacher JG, Tampe B, Korsten P. First Report of Two Cases of Löfgren's Syndrome after SARS-CoV-2 Vaccination-Coincidence or Causality? Vaccines (Basel). 2021 Nov 11;9(11):1313. doi: 10.3390/vaccines9111313. PMID: 34835244; PMCID: PMC8619392. DOI: https://doi.org/10.3390/vaccines9111313
Polat Ekinci A, Büyükbabani N, Meşe S, Pehlivan G, Okumuş NG, Ağaçfidan A, Özkaya E. COVID-19-triggered sarcoidal granulomas mimicking scar sarcoidosis. J Eur Acad Dermatol Venereol. 2021 Aug;35(8):e477-e480. doi: 10.1111/jdv.17286. Epub 2021 May 1. PMID: 33871106; PMCID: PMC8250646. DOI: https://doi.org/10.1111/jdv.17286
WIGLEY JE, MUSSO LA. A case of sarcoidosis with erythrodermic lesions. Treatment with calciferol. Br J Dermatol. 1951 Nov;63(11):398-406. doi: 10.1111/j.1365-2133.1951.tb13677.x. PMID: 14895781. DOI: https://doi.org/10.1111/j.1365-2133.1951.tb13677.x
LEVER WF, FREIMAN DG. Sarcoidosis; report of an atypical case with erythrodermic lesions, subcutaneous nodes and asteroid inclusion bodies in giant cells. Arch Derm Syphilol. 1948 Apr;57(4):639-54. doi: 10.1001/archderm.1948.01520170037005. PMID: 18886273. DOI: https://doi.org/10.1001/archderm.1948.01520170037005
NAGAI R, KATO Y. [Erythrodermic sarcoid]. Hautarzt. 1962 Dec;13:550-2. German. PMID: 13937100.
Morrison JG. Sarcoidosis in a child, presenting as an erythroderma with keratotic spines and palmar pits. Br J Dermatol. 1976 Jul;95(1):93-7. doi: 10.1111/j.1365-2133.1976.tb15538.x. PMID: 133705. DOI: https://doi.org/10.1111/j.1365-2133.1976.tb15538.x
Mittag H, Rupec M, Kalbfleisch H, Schmitz-Reinhardt R. Zur Frage der erythrodermischen Sarkoidose (Eine klinische, licht- und elektronenmikroskopische Untersuchung) [Erythrodermic sarcoidosis (a clinical, light and electron microscopy study)]. Z Hautkr. 1986 May 15;61(10):673-87. German. PMID: 2940757.
Acciai MC, Mori M, Cappugi P. Sarcoidosi eritrodermica [Erythrodermic sarcoidosis]. G Ital Dermatol Venereol. 1990 Oct;125(10):475-7. Italian. PMID: 2150510.
Gregg PJ, Kantor GR, Telang GH, Lessin SR, Nowell PC, Vonderheid EC. Sarcoidal tissue reaction in Sézary syndrome. J Am Acad Dermatol. 2000 Aug;43(2 Pt 2):372-6. doi: 10.1067/mjd.2000.101593. PMID: 10901727. DOI: https://doi.org/10.1067/mjd.2000.101593
Yoon CH, Lee CW. Case 6. Erythrodermic form of cutaneous sarcoidosis. Clin Exp Dermatol. 2003 Sep;28(5):575-6. doi: 10.1046/j.1365-2230.2003.01359.x. PMID: 12950367. DOI: https://doi.org/10.1046/j.1365-2230.2003.01359.x
Park SK, Hwang PH, Yun SK, Kim HU, Park J. Tumor Necrosis Factor Alpha Blocker-Induced Erythrodermic Sarcoidosis in with Juvenile Rheumatoid Arthritis: A Case Report and Review of the Literature. Ann Dermatol. 2017 Feb;29(1):74-78. doi: 10.5021/ad.2017.29.1.74. Epub 2017 Feb 3. PMID: 28223750; PMCID: PMC5318531. DOI: https://doi.org/10.5021/ad.2017.29.1.74
Supporting Agencies
NoneCopyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
