Abstract
Background: Granuloma annulare (GA) is a benign, self-limiting inflammatory skin condition of unknown origin that may occur following multiple etiological triggers. GA incited secondary to vaccinations has been rarely reported in the medical literature. The COVID-19 pandemic has introduced extensive global immunization against the SARS-COV-2 virus, bringing a gamut of vaccine-related complications. We elucidate a case report of the spontaneous eventuality of GA following ChAdOx1 nCoV-19 Corona Virus Recombinant Vaccine.
 Case Report: A healthy 26-year male presented with a one-week history of asymptomatic single, flesh-pink patch with a raised margin over his left ventral forearm. On close examination, the margin of the lesion had multiple annularly arranged papules. Biopsy of lesion was done, and histopathology revealed numerous palisading granulomas in the dermis consistent with findings of localized GA. The patient was managed with once-daily external application high potent topical corticosteroids, which was used intermittently by the patient. However, the lesion showed spontaneous resolution in one month.
 Conclusion: Identifying ChAdOx1 nCoV- 19 Vaccine-related adverse events following its first dose is paramount, as evidence of the proportion of local or systemic severe cutaneous adverse skin reaction (SCAR) on subsequent dosing is a paucity. A more extensive systematic review corroborating SCARs and safety profile following immunization with ChAdOx1 nCoV-19 Vaccine prevails to be the need of the hour.
Highlights
Granuloma annulare (GA) is a benign, idiopathic, self-limiting inflammatory skin condition commonly reported following trauma, insect bites, viral infections, and malignancy [1,2]
Few cases describe the spontaneous occurrence of granuloma annulare following vaccinations
We describe a case of GA-like eruption following ChAdOx1 nCoV- 19 Corona Virus Recombinant Vaccine in a young Indian male who has no medical history nor allergies
Summary
Granuloma annulare (GA) is a benign, idiopathic, self-limiting inflammatory skin condition commonly reported following trauma, insect bites, viral infections, and malignancy [1,2]. Few cases describe the spontaneous occurrence of granuloma annulare following vaccinations. With the ongoing extensive global immunization program against the SARS-CoV-2 virus, global distribution of 7.41 billion doses has been administered that covered 51.5% of the world population to have at least one dose of COVID19 vaccine [3]. Anecdotal reports on the cutaneous adverse reactions following COVID-19 immunization form lacunae in their early diagnosis and active medical management. We describe a case of GA-like eruption following ChAdOx1 nCoV- 19 Corona Virus Recombinant Vaccine in a young Indian male who has no medical history nor allergies
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