2022 Jul 8;101(27):e29823. Numerous scattered erythematous plaques with fine scale oriented along skin cleavage lines, most appreciable on the upper portion of the chest. An official website of the United States government. See this image and copyright information in PMC. Variable dermatological manifestations including acral erythema, urticaria, vasculitis, vesicular or pustular eruptions, maculopapular rash have all been reported during the course of COVID19. J Formos Med Assoc. 2022 Oct 4;15:2117-2127. doi: 10.2147/CCID.S371630. 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. We present a case of a pityriasis rosea-like rash occurring after Pfizer COVID-19 vaccination and review cases of pityriasis rosea (PR)/PR-like eruption (PR-LE) after mRNA COVID-19 vaccine published in the medical literature. In: Knoop KJ, Stack LB, Storrow AB, et al., eds. Vaccination is one of the cornerstones in the efforts towards ending the coronavirus disease 2019 (COVID-19) pandemic. J Eur Acad Dermatol Venereol. Moreover, almost all lesions faded with associated post-inflammatory hyperpigmentation (Figure 2B). Disseminated erythematous-papulosquamous lesions, with right laterocervical herald patch (clinical aspect on admission). Pityriasis rosea commonly affects the skin on your trunk, arms or legs. 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. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291919/). The site is secure. 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). Epub 2022 Jun 26. 78 PDF Pityriasis rosea following CoronaVac COVID19 vaccination: a case report Elin Akda, N. Ilter, B. t, . Erdem 2022 Jan;114:88-89. doi: 10.1016/j.ijid.2021.10.055. Pityriasis rosea following CoronaVac COVID-19 vaccination: a case report. Patient concerns: Coronavirus disease 2019 and pityriasis rosea: A review of the immunological connection. 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. I put on some hydrocortisone and went to sleep, then woke up with another mark on my side, a couple inches below my armpit. Some treatments can alleviate related symptoms, including itching. 7 Articles, This article is part of the Research Topic, Creative Commons Attribution License (CC BY), Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. Drug-induced PR-like eruption accounts for 2% of all cutaneous adverse drug reactions (10). 2021 Dec;108(6):317-318. doi: 10.12788/cutis.0411. Suchonwanit P, Leerunyakul K, Kositkuljorn C. Cutaneous manifestations in COVID-19: Lessons learned from current evidence. J Invest Dermatol. In a registry-based study, PR-like eruption was observed in only 12% of patients (14). Rationale: Epub 2020 Jun 29. HHS Vulnerability Disclosure, Help doi: 10.1111/jdv.17342. Clipboard, Search History, and several other advanced features are temporarily unavailable. The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s. Bathe or shower in lukewarm water. Cutis. -, Drago F, Ciccarese G, Rebora A, Parodi A. A 3-cm oval plaque with peripheral scale, larger than the other lesions, was present on the inferior portion of the right breast. Br J Dermatol 2020; 183: 431442. Coronavirus pandemic (COVID-19), McMahon D.E., Amerson E., Rosenbach M., et al. Epub 2021 Jul 21. 2022 May;121(5):1003-1007. doi: 10.1016/j.jfma.2021.12.028. and transmitted securely. Disclaimer. You may be at risk of developing an allergic reaction on your skin. Indian J Dermatol 2016;61:37584. In approximately 50% of people with pityriasis rosea, the patches itch. 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). 2021;85(1):4655. Pityriasis rosea, COVID-19 and vaccination: new keys to understand an old acquaintance. Pityriasis is linked mainly with herpesviruses 6 and 7; only a . Histopathological findings of pityriasis rosealike eruption in patient 1. (2020) 83:e5760. Keywords: No one knows what causes pityriasis rosea, though healthcare experts think a virus might be responsible. Fortunately, PR-like eruption is responsive to topical corticosteroids without any systemic adverse effects. Unauthorized use of these marks is strictly prohibited. This site needs JavaScript to work properly. 2022 Nov;36(11):1947-1968. doi: 10.1111/jdv.18294. Published by Elsevier Inc. Pityriasis rosea. 2021;185(2):e34. (2021) 35:e4913. J Am Acad Dermatol. doi: 10.1111/j.0022-202X.2005.23719.x. Federal government websites often end in .gov or .mil. Flares of other types of skin conditions [like psoriasis] sometimes have been described as well," says Lam. Clin Dermatol. doi: 10.1111/ijd.13061. In conclusion, we have described the first case of PR-like eruption following ChAdOx1 nCoV-19 (Oxford/AstraZeneca) vaccination. -, Cyrenne BM, Al-Mohammedi F, DeKoven JG, Alhusayen R. Pityriasis rosea-like eruptions following vaccination with BNT162b2 mRNA COVID-19 vaccine. Epub 2021 Jun 10. Pityriasis lichenoides has distinct acute and chronic forms, which are usually distinct . Pityriasis rosea following SARS-CoV-2 vaccination: A case series. Physical examination revealed that lesions were distributed along cleavage lines, similar to PR, without herald patch or prominent scales (Figure 1C). See this image and copyright information in PMC. (b) haematoxylineosin, original magnification 20. The symptoms of pityriasis rosea usually develop in stages: Pityriasis rosea doesnt hurt. Disclaimer. The evolution was unfavorable, with the spread of the lesions and the accentuation of the pruritus. Med Clin (Barc). eCollection 2022 Feb. Kroumpouzos G, Paroikaki ME, Yumeen S, Bhargava S, Mylonakis E. Microorganisms. Hardin J. Pityriasis Rosea. The average time between vaccination and rash onset is 10 days, and most patients experience pruritus (70%). HHS Vulnerability Disclosure, Help government site. The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of Cond Nast. About one to two weeks later, discolored circular or oval-shaped patches appear in groups near the herald patch. Careers. Federal government websites often end in .gov or .mil. Epub 2021 Apr 26. This Month in JAAD International: August 2022: Cutaneous reactions to COVID-19 messenger RNA booster dose vaccination. Copyright 2021 Leerunyakul, Pakornphadungsit and Suchonwanit. Disclaimer. doi: 10.1111/jdv.12942, 13. Table 1 summarizes all reported cases of PR-like eruption following COVID-19 vaccination. Epub 2022 Jan 31. Some people develop a few large patches on their skin. 9 , 10 These findings suggest that immuneinduced viral reactivation - rather than government site. Accessibility Interventions: An official website of the United States government. . At home, she underwent systemic treatment with antihistamines and topical medication with dermatocorticosteroids. Nevertheless, the incidence of skin reactions after mRNA vaccinations was low. The https:// ensures that you are connecting to the It is increasingly recognized that SARS-CoV-2 infection and COVID-19 vaccines have been associated with skin disorders, including pityriasis rosea. Cutaneous reactions after COVID-19 vaccination in Turkey: A multicenter study. 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. While you don't need to treat the rash, some patients ask for treatment to take care of the following. Involvement of the oral mucosa has also been reported in as many as 50% of all cases (11). The appearance of pityriasis rosea following the first injection of the AstraZeneca vector vaccine suggests a causal connection. Epub 2020 Nov 20. Unable to load your collection due to an error, Unable to load your delegates due to an error. Another skin condition identified in the study were "vesicular eruptions" seen in 9 per cent of cases. It is likely that a new viral trigger of pityriasis rosea is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). (a) Patient 1: Thin red to tan oval plaques with peripheral scale on the trunk. NCI CPTC Antibody Characterization Program, Ehsani AH, Nasimi M, Bigdelo Z. Pytiriasis rosea as a cutaneous manifestation of COVID-19 infection. Some patients may have a cold before the rash. 2021 Sep;60(9):1150-1151.doi: 10.1111/ijd.15700. Accessibility Your symptoms dont improve after treatment. Pityriasis rosea usually resolves on its own without treatment in most cases, King says, but topical corticosteroids can be used for itchy control if necessary, which is what I used. doi: 10.1111/jdv.17498. The exanthem was self-limited in both patients over a period of a month. Rashes should be considered a "key diagnostic sign" of Covid-19, according to a study, which found 8% of people who test positive for the virus have some form of rash. Moreover, while dermoscopy may facilitate the diagnosis of PR, its utility for atypical PR or PR-like lesions is still limited. See this image and copyright information in PMC. Cutaneous manifestation has been reported in 0.2% of patients infected by COVID-19 in China, and 18 out of 88 patients from Italy. The patient presented to the Department of Dermatology for a 3 week duration of an extremely pruritic erythematous-squamous lesion, initially on the trunk and upper limbs, with extension to the lower limbs in the last week and the lesion respected the cephalic extremity, palms, and soles. Policy. 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. 1 Several vaccines have been developed to fight against COVID19, to prevent the transmission among susceptible individuals and to decrease the morbidity (Within two days, and still no.) 2020 Sep 25;155(6):273. doi: 10.1016/j.medcli.2020.05.024. The https:// ensures that you are connecting to the The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Apply a moisturizer, calamine lotion or a nonprescription . COVID-19; SARS-CoV-2; pityriasis rosea; vaccination. COVID-19 has been reported as one such viral trigger for PR. The patches may itch. -, Welsh E, Cardenas-de la Garza JA, Cuellar-Barboza A, Franco-Marquez R, Arvizu-Rivera RI. Treatment may include various topical and oral drugs. official website and that any information you provide is encrypted PS conceptualized the case report and revised the manuscript. However, in cases of atypical PR, it may present with erythema multiforme-like lesions and purpura (5). Pityriasis Rosea. The significance of investigating clinical, histopathologic and virological features in pityriasis rosea and pityriasis rosea-like eruptions following COVID-19 vaccinations. While unusual, one patient developed pityriasis rosea once a year for five years in a row. FOIA Alamri A, Alghamdi Y, Alamri SJ, Althaqafi MK, AlQurashi W, Bader BA, Mohanna AT, Almahdi B. Cureus. Contact your healthcare provider as soon as you notice a rash. JAAD Int. National Library of Medicine -. Birlutiu V, Dobritoiu ES, Lupu CD, Herteliu C, Birlutiu RM, Dragomirescu D, Vorovenci A. How can you tell that I have pityriasis rosea? [Epub ahead of print]. 2023 Feb 9;11(2):397. doi: 10.3390/vaccines11020397. However, a fungus causes ringworm. FOIA Ad Choices. Fried foods, including many fast-food items. doi: 10.1111/dth.13730. Federal government websites often end in .gov or .mil. 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. An official website of the United States government. Before Pityriasis means scaly, and rosea means pink, but the rashes may look red, gray, brown or purple. Ciccarese G, Parodi A, Drago F. SARS-CoV-2 as possible inducer of viral reactivations. 2022 Oct;49(10):948-956. doi: 10.1111/1346-8138.16482. NCI CPTC Antibody Characterization Program, Ritchie H., Mathieu E., Rodes-Guirao L., et al. The authors suggest more research is necessary. Human herpesviruses 6 and 7 are common. Epub 2022 Jun 13. Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Clin Cosmet Investig Dermatol. The Moderna and Pfizer-BioNTech COVID-19 vaccines are the first two COVID-19 vaccines authorized by the Food and Drug Administration for emergency use and already have been given to millions of Americans. Central dusky-red erythematous on some plaques (A); almost all lesions fading with associated post-inflammatory hyperpigmentation after treatment (B). Dermatol Ther. Herald patch of pityriasis rosea. Epub 2022 Feb 9. 8600 Rockville Pike 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. Before FOIA Before While my particular flare-up itched a lot, that's not always the case. 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. (2015) 2015:253154. doi: 10.1155/2015/253154, 14. However, some people believe that eating an anti-inflammatory diet may relieve itching. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Bethesda, MD 20894, Web Policies and transmitted securely. Unfortunately, due to her deteriorating neurologic status, her associated symptoms were not evaluated properly. 2021;35(8):e489e491. Under the treatment that was initiated a partial remission of the lesions after 7 days was observed. Disclaimer. You may develop a raised, discolored, circular or oval-shaped patch that ranges from 1 to 6 centimeters (cm). Would you like email updates of new search results? Safety and efficacy of the BNT162b2 mRNA Covid19 vaccine. National Library of Medicine Clipboard, Search History, and several other advanced features are temporarily unavailable. MeSH 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. Careers. Figure 3. J Am Acad Dermatol. The following self-care tips may help relieve the discomfort of pityriasis rosea: Take nonprescription allergy medicine (antihistamines), such as diphenhydramine (Benadryl, others). Rybak-d'Obyrn J, Placek W, Owczarczyk-Saczonek A, Derkaczew M, Joniec E, Hofman R, Stompr M. Clin Cosmet Investig Dermatol. Unable to load your collection due to an error, Unable to load your delegates due to an error. Leerunyakul K, Pakornphadungsit K, Suchonwanit P. Front Med (Lausanne). Pityriasis Rosea Associated With COVID-19 Vaccination: A Common Rash Following Administration of a Novel Vaccine. Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review. 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 Unable to load your collection due to an error, Unable to load your delegates due to an error. An official website of the United States government. If you need help purchasing a product directly from Allure, go to our FAQ. 2021 Aug;185(2):e34. National Library of Medicine Histopathological Patterns of Cutaneous Adverse Reaction to Anti-SARS-CoV-2 Vaccines: The Integrative Role of Skin Biopsy. Your healthcare provider can typically diagnose pityriasis rosea after a physical exam. 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. Suchonwanit P, Leerunyakul K, Kositkuljorn C. Diagnostic and prognostic values of cutaneous manifestations in COVID-19. 2021 Oct;20(10):3080-3084. doi: 10.1111/jocd.14372. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases. 2021 Dec;108(6):317-318. doi: 10.12788/cutis.0411. 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. Bookshelf However, if you experience any symptoms, therapy can provide relief. J Eur Acad Dermatol Venereol 2016; 30: 544-545. Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. This article presents a case of PR in a 66-year-old black male 1 week after administration of the Pfizer-BioNTech COVID-19 vaccine. Authors Elina Khattab 1 , Eirini Christaki 2 , Constantinos Pitsios 1 Affiliations 1 Medical School, University of Cyprus, Nicosia, Cyprus. FOIA eCollection 2022 Jul. Pityriasis rosea: An update on etiopathogenesis and management of difficult aspects. Drago F, Ciccarese G, Javor S, et al. Shabazz DR. Pityriasis Rosea. Oueijan RI, Hill OR, Ahiawodzi PD, Fasinu PS, Thompson DK. Pityriasis Rosea Associated With COVID-19 Vaccination: A Common Rash Following Administration of a Novel Vaccine. They develop in a pattern that resembles sagging Christmas tree branches. Federal government websites often end in .gov or .mil. doi: 10.1111/bjd.20143. doi: 10.1159/000517971. NCI CPTC Antibody Characterization Program. Your California Privacy Rights. Keywords: J Am Acad Dermatol. Numerous scattered erythematous, Pityriasis rosea. Treatment with topical 0.1% triamcinolone acetonide twice per day showed partial response after seven days. government site. Medicines (Basel). Pityriasis rosea (PR)-like eruption is a cutaneous complication associated with several medications and vaccinations. J Med Virol. Dermatol Reports. Parakeratosis with minimal acanthosis, MeSH The Covid Symptom Study. doi: 10.7759/cureus.22414. Med. The papillary dermis shows melanin incontinence, perivascular lymphocytic infiltrate and rare scattered extravasated red blood cells. This site needs JavaScript to work properly. FOIA However, the studies dont conclusively prove that COVID-19 causes pityriasis rosea. This site needs JavaScript to work properly. The clinics of HHV-6 infection in COVID-19 pandemic: Pityriasis rosea and Kawasaki disease. Medicine (Baltimore). 2021 Jul;85(1):46-55. doi: 10.1016/j.jaad.2021.03.092. 2022 Aug;35(8):e15601. Drago F, Ciccarese G, Parodi A. Pityriasis rosea and pityriasis rosea-like eruptions: How to distinguish them? Pityriasis rosea (PR)-like eruption is a rare cutaneous complication of immunization. This rash is thought to be caused by a virus. Diagnoses: . A team of researchers . and transmitted securely. Due to the rising incidence of coronavirus disease 2019 (COVID-19) worldwide, mass vaccination has been the cornerstone in preventing viral spread and decreasing morbidity and mortality. Atypical pityriasis rosea associated with mRNA COVID19 vaccine E. Bostan, Adam Jarbou Published 29 September 2021 Medicine Journal of Medical Virology Variable dermatological manifestations including acral erythema, urticaria, vasculitis, vesicular or pustular eruptions, maculopapular rash have all been reported during the course of Covid-19. Ramot Y, Nanova K, Faitatziadou SM, Assab DA, Berkun Y, Zlotogorski A. J Dtsch Dermatol Ges. 2023 Cond Nast. Figure 1. 2005;124(6):12341240. 2021 Aug;185(2):e34. Outcome: Pityriasis rosea is also known as Christmas tree rash. Epub 2022 Jan 31. The site is secure. FOIA It has been reported that pityriasis rosea has been triggered by several vaccines, as a rare side-effect. HHS Vulnerability Disclosure, Help Please enable it to take advantage of the complete set of features! A virus may cause pityriasis rosea, but experts arent sure. 2022 Jul 21;14(7):e27108. Clipboard, Search History, and several other advanced features are temporarily unavailable. Lessons: Similar to other viral outbreaks, people can experience flu-like symptoms like a fever, aches, or a runny nose when the herald patch shows up, Lam says, though I was lucky enough to skip that step. Cleveland Clinic is a non-profit academic medical center. However, several adverse effects of COVID-19 vaccination have been identified. 2021 May;62(2):e333-e334. Histopathologic features: (B) microscopic image at a low power field showing psoriasiform epidermal hyperplasia, perivascular infiltration, and interface dermatitis (hematoxylin-eosin; scale bar represents 100 m); (C) microscopic image at a high power field showing focal spongiotic dermatitis, interface dermatitis, and perivascular infiltration of lymphocytes and eosinophils (hematoxylin-eosin; scale bar represents 40 m). Epub 2021 Aug 7. eCollection 2022. (c) Patient 2: Thin red to tan oval plaques with peripheral scale on the trunk and proximal thigh. Authors Lina Abdullah 1 Most of the rare, severe allergic reactions to these vaccines have occurred in people with a history of allergies. Epub 2022 Jul 19. These conditions lasted 8.6 days on average. Pityriasis rosea, pityriasis rosea-like eruptions, and herpes zoster in the setting of COVID-19 and COVID-19 vaccination. Bethesda, MD 20894, Web Policies It looked like one, and it certainly itched like one but then more came. Bethesda, MD 20894, Web Policies HHS Vulnerability Disclosure, Help and transmitted securely. official website and that any information you provide is encrypted Temiz SA, Abdelmaksoud A, Dursun R, Durmaz K, Sadoughifar R, Hasan A. J Cosmet Dermatol. Epub 2022 Jun 21. -, Polack FP, Thomas SJ, Kitchin N et al. Pityriasis rosea (PR)-like eruption is a cutaneous complication associated with several medications and vaccinations. Bookshelf Adya KA, Inamadar AC, Albadri W. Post Covid-19 vaccination papulovesicular pityriasis rosea-like eruption in a young male. Here, we describe a case of PR-like eruption following ChAdOx1 nCoV-19 (AZD1222) vaccination in a Thai patient with glioblastoma. Here, we described a case of PR-like eruption that developed 14 days after Oxford/AstraZeneca vaccination in a 52-year-old Thai woman with glioblastoma. We present two cases of COVID-19 vaccine-induced pityriasis rosea. 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. 2022 Oct;123:58-69. doi: 10.1016/j.ijid.2022.06.037. 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. 2022 Sep-Oct;40(5):586-590. doi: 10.1016/j.clindermatol.2022.01.002. Cured meats with nitrates, such as hot dogs. Appointments 216.444.5725 Appointments & Locations Request an Appointment Washrawirul C, Triwatcharikorn J, Phannajit J, Ullman M, Susantitaphong P, Rerknimitr P. J Eur Acad Dermatol Venereol. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article. doi: 10.1111/dth.13878, 10. From grooming sets to self-care gadgets, we've got them covered. If you have pityriasis rosea, you dont have to avoid any foods or drinks. You cant spread pityriasis rosea to another person through unprotected sex or skin-to-skin contact.