Erythrodermic psoriasis eruption following COVID-19 vaccination

Abstract

Sir, Psoriasis is a chronic inflammatory skin condition affecting roughly 2% of the population. Erythrodermic psoriasis (EP) is its rare and severe variant [1]. It is characterized by acute flare-ups induced by various factors, yet some reports have described the onset or flare-up of EP induced by vaccination. To our knowledge, only two such cases following COVID-19 vaccination have been reported. Herein, we report a case of an EP flare-up after COVID-19 vaccination. A 47-year-old male was referred by our emergency department with diffuse erythema, desquamation, fever, and a poor general condition, arising ten days after the reception of the first dose of the Sinopharm vaccine. He had a history of plaque psoriasis, yet used only topical treatments. He denied any past vaccination-related reaction, recent medication changes, or recent infection. A physical examination revealed diffuse erythema and desquamation on the entire body (Fig. 1a). Initial laboratory investigation revealed hyperglycemia and incidentally discovered diabetes. A COVID-19 PCR test was negative and the peripheral blood smear was normal. He had no history of malignancy and the tumor marker tests were negative. Histopathology was also compatible with erythrodermic psoriasis. He was, thus, diagnosed with the exacerbation of erythrodermic psoriasis associated with the administration of CoronaVac. We commended methotrexate and local treatment with very good improvement.