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Oral erythema multiforme after Pfizer-BioNTech COVID-19 vaccination: a report of four cases

Massimo Petruzzi1,2, Sara Galleggiante1, Sabrina Messina1

  • 1Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy.

BMC Oral Health
|March 25, 2022
PubMed

Insights

Four patients experienced oral erythema multiforme flares after receiving the BNT162b2 COVID-19 vaccine. This rare side effect, potentially linked to the vaccine or reactivated herpes virus, was treated with corticosteroids.

Area of Science:

  • Dermatology
  • Immunology
  • Vaccinology

Background:

  • The COVID-19 pandemic necessitates widespread vaccination, with BNT162b2 being a key vaccine.
  • Adverse events following vaccination are documented, including various cutaneous reactions.
  • Erythema multiforme is a recognized mucocutaneous reaction pattern.

Observation:

  • Four cases of oral erythema multiforme flares post-BNT162b2 vaccination are presented.
  • Patients had no prior history of similar lesions or herpes infections.
  • Lesions appeared after the first or second vaccine dose, with some cases showing both oral and cutaneous involvement.

Findings:

  • The BNT162b2 vaccine may trigger erythema multiforme flares.
  • The exact causal link is unproven, but medication-induced erythema multiforme is known.
  • Reactivation of latent herpes virus infection by the vaccine is a potential mechanism.

Implications:

  • Highlights a rare potential adverse effect of the BNT162b2 COVID-19 vaccine.
  • Suggests vigilance for mucocutaneous reactions post-vaccination.
  • Warrants further investigation into vaccine-associated erythema multiforme and herpes virus reactivation.
Abstract

Keywords:
Adverse reactionBioNTech/PfizerCase reportCovid-19 vaccineErythema multiforme

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