key: cord-0994618-jo13foe0
authors: Burlando, Martina; Russo, Roberto; Cozzani, Emanuele; Parodi, Aurora
title: COVID‐19 “second wave” and vaccines: the dermatologists’ perspective
date: 2021-03-25
journal: Int J Dermatol
DOI: 10.1111/ijd.15547
sha: bfbf4fd8fc8b3efab18edad3119f492faa48005d
doc_id: 994618
cord_uid: jo13foe0

nan

by the World Health Organization on March 11, 2020. During the first months, cutaneous manifestations of the SARS-CoV-2 infection were continuously being reported. A potential correlation between cutaneous aspects and severity degrees of the disease has been hypothesized, albeit never demonstrated. 1 However, there is considerable interest surrounding the dermatological aspects of COVID-19. Starting in late August 2020, a "second wave" of COVID-19 cases broke out in Western countries. Literature investigating the differences in cutaneous manifestations between the first and second wave of the pandemic is scanty. A second outbreak of chilblain-like acral lesions in pediatric patients was reported concurrently with the second wave of the pandemic, although the authors did not report any data concerning incidence during the first and the second wave; moreover, the relationship between these skin lesions and SARS-CoV-2 infection is yet to be demonstrated. 2 (Fig. 1) . Herpes zoster was diagnosed; acyclovir 800 mg was given five times a day for 7 days, with prompt resolution.

Case 2 was a 47-year-old emergency room physician with no comorbidities, previously diagnosed with lichen planus located on both forearms; he experienced a sudden worsening of the preexisting papules, which spread to both arms and trunk, the day after vaccination (Fig. 2) . The patient refused a biopsy; topical corticotherapy applied twice a day for 10 days resolved the reaction.

Lichenoid reactions and herpes zoster are uncommon vaccine-related complications, although they have been reported after vaccinations, for example, following immunization for In conclusion, it is crucial to monitor and to collect reports of any and all cutaneous adverse events, in order to understand the efficacy and safety of the vaccines. Furthermore, large studies on prospective cohorts and/or registry studies need to be designed since the mass vaccination of healthcare workers provides an excellent opportunity to collect data and therefore increase and improve the quality of the available evidence.

Dermatologists should be involved in the immunization campaigns, as vaccinated patients should be promptly offered dermatologic evaluation when needed. Therefore, pharmacosurveillance is imperative, and the COVID-19 challenge is not yet over for dermatologists. 

Six months into the pandemic. A review of skin manifestations in SARS-CoV-2 infection

Chilblain-like lesions and COVID-19: second wave, second outbreak

Lack of skin manifestations in COVID-19 hospitalized patients during the second epidemic wave in Spain: a possible association with a novel SARS-CoV-2 variant -a cross-sectional study

Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine

Lichen planus and lichenoid drug eruption after vaccination

Severe Herpes Zoster following varicella vaccination in immunocompetent young children

Herpes Zoster in the older adult

Fixed drug eruptions, bullous drug eruptions, and lichenoid drug eruptions

Funding source: None. doi: 10.1111/ijd.15547