key: cord-0906804-thepbcv6
authors: Mieczkowska, Karolina; Kaubisch, Andreas; McLellan, Beth N.
title: Exacerbation of psoriasis following COVID‐19 vaccination in a patient previously treated with PD‐1 inhibitor
date: 2021-07-17
journal: Dermatol Ther
DOI: 10.1111/dth.15055
sha: f6be7d3f71ac8617f4302940205e4aa97ebca19b
doc_id: 906804
cord_uid: thepbcv6

nan

Exacerbation of psoriasis following COVID-19 vaccination in a patient previously treated with PD-1 inhibitor Dear Editor, Psoriasis is a cutaneous immune-mediated inflammatory disease resulting from a combination of polygenic and environmental factors.

Various endogenous and exogenous triggers have been observed to initiate the onset or exacerbation of the disease via a T-cell mediated response. 1 We present a case of a patient who experienced exacerbation of psoriasis after receiving the BNT162b2 vaccine against SARS-CoV-2. Our patient had previously been treated with nivolumab, which is also known to trigger and exacerbate psoriasis; however, this medication was discontinued 3 months prior to this flare with some subsequent improvement in his psoriasis. 7 Furthermore, influenza vaccination during active immunotherapy treatment for cancer appears to result in higher rates of vaccine-mediated immunologic side effects. 8 Consequently, it is unknown if prior treatment with PD-1 inhibitor immunotherapy predisposed our patient to a vaccinemediated autoimmune disease flare.

Given psoriasis exacerbations have been reported after infections and immunizations, our case demonstrates that flares following the vaccine are possible. Three other cases of psoriasis flares after the COVID-19 vaccine have been documented in the literature. 9, 10 F I G U R E 1 Erythematous scaly plaques throughout the chest, abdomen, back, and extremities

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