A case series of interesting mucocutaneous presentations in COVID-19
infection or post COVID-19 vaccination confirmed by biopsy and
histopathologic assessment
Abstract
Mucocutaneous complications or adverse events due to SARS-CoV-2
infection or vaccination have been well-delineated in the literature,
respectively. Most eruptions are considered to be mild and
self-limiting; however, for the atypical cases which have a tentative
clinical diagnosis, performing a biopsy and histopathological assessment
is pivotal to confirm the diagnosis and subsequently prescribe a more
tailored treatment. Despite the diverse reporting of such incidents
globally, the rate of biopsied cases is restricted to less than 15% in
most studies. This case series elucidates 20 patients referred to the
tertiary dermatology clinic, including 14 COVID-19 infection-related
eruptions such as Lichen Planus (LP), Cutaneous vasculitis, Pityriasis
rosea (PR), Discoid lupus erythematosus, Guttate psoriasis, Sarcoidosis,
Raynaud’s phenomenon, non-specific lesions resembling genital warts,
Beau’s line and one severe case of purpura fulminans with a promising
outcome. Moreover, we presented 6 vaccine-induced cases comprising LP,
Urticarial vasculitis, PR, Parapsoriasis, and Localized Morphea. The
diagnosis of all cases has been proven by histopathological evaluation.
We included pertaining anamnesis details of each patient together with
vivid classifying images to pinpoint the morphologic features of each
condition. In line with our previous studies, the vaccine-induced
eruptions were less severe compared to infection-related complications
of COVID-19 and are mostly controllable by antihistamines and
corticosteroids administration. Therefore, reporting such events should
not hinder COVID-19 vaccination in the general population.