key: cord-0962661-3tjrw1jb
authors: Cohen, Stephanie R.; Prussick, Lisa; Kahn, Jared S.; Gao, David X.; Radfar, Arash; Rosmarin, David
title: Leukocytoclastic vasculitis flare following the COVID‐19 vaccine
date: 2021-04-30
journal: Int J Dermatol
DOI: 10.1111/ijd.15623
sha: 6fb0640f9e9cce203b5b79c013d61564f1ab8d9e
doc_id: 962661
cord_uid: 3tjrw1jb

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Two messenger ribonucleic acid (mRNA) vaccines were authorized for emergency use by the United States Food and Drug Administration (U.S. FDA) against the Coronavirus Disease 2019 (COVID-19) at the end of 2020. 1 Immunization is a significant milestone in fighting this pandemic; however, safety regarding special populations has yet to be determined. We report a case of a patient who suffered from vasculitis after COVID-19 vaccination. virus may provoke hyperactivation of the immune system secondary to cross-reactivity and molecular mimicry between the virus and self-antigens, consequently triggering autoimmune disorders such as vasculitis, antiphospholipid syndrome, immune-mediated myositis, and myocarditis. 3 Before the COVID-19 vaccine became available, it was suspected that a similar scenario might happen following its administration. It is notable that despite a diagnosis of psoriasis and psoriatic arthritis, the patient had no exacerbation in these T helper 17 (Th17)-mediated diseases.

Our patient was prescribed a prednisone taper. There is concern regarding prescribing such immunomodulatory agents shortly after vaccines. However, it has been reported that systemic steroids cause variable effects on immunity, which is dose-dependent. Up to 20 mg/day of prednisone seems to not have any effect on patients' immune response to vaccines. For the COVID-19 vaccine, it is speculated that regardless of the type of vaccine, systemic corticosteroids have "no or minimal risk" in patients' immune response. 4 It is important for healthcare providers and patients to be aware that the COVID-19 vaccine can potentially precipitate or 

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