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Morbilliform Eruption After Administration of Second Dose of Oxford/AstraZeneca Vaccine
Norah S Alhammad1, Heba H Milibary2, Razan R Baghdadi3
1Dermatology, King Fahad Armed Forces Hospital, Jeddah, SAU.
Abstract:
Morbilliform eruption typically implies a maculopapular rash of acute onset. Drugs are the predominant cause of this cutaneous reaction in adults, followed by infectious exanthems and some rheumatological diseases. In this article, we report on the clinical and histopathological features of generalized pruritic morbilliform eruption in a 28-year-old female following her second dose of Oxford/AstraZeneca COVID-19 vaccine. The reaction started 12 hours after receiving the vaccine with no other identifiable cause. The patient had no improvement with IV antihistamine received in the emergency department. Afterward, she showed marked improvement after receiving a short course of oral corticosteroids along with topical corticosteroid and oral antihistamine. To the best of our knowledge, we hypothesize that the basic immunological mechanism is the cause behind COVID-19-vaccine-related morbilliform eruption. Therefore, physicians should be aware of the possible adverse reactions associated with COVID-19 vaccines, such as morbilliform eruptions and other cutaneous manifestations.
Insights
A morbilliform rash, a common vaccine side effect, occurred in a woman 12 hours after her COVID-19 vaccine. Oral corticosteroids effectively treated this generalized pruritic eruption.
Area of Science:
- Dermatology
- Immunology
- Vaccinology
Background:
- Morbilliform eruptions are typically acute maculopapular rashes.
- Common causes include drugs, infections, and rheumatological diseases.
- COVID-19 vaccines are a potential trigger for cutaneous reactions.
Observation:
- A 28-year-old female developed a generalized pruritic morbilliform eruption 12 hours post-Oxford/AstraZeneca COVID-19 vaccination.
- The reaction was unrelated to other identifiable causes.
- Initial treatment with intravenous antihistamines was ineffective.
Findings:
- The patient experienced significant improvement with a short course of oral corticosteroids, topical corticosteroids, and oral antihistamines.
- Histopathological features were documented.
- The eruption resolved following corticosteroid therapy.
Implications:
- COVID-19 vaccines, including Oxford/AstraZeneca, can cause morbilliform eruptions.
- Physicians should recognize and manage vaccine-related cutaneous adverse events.
- Understanding the immunological mechanisms of vaccine-induced rashes is crucial for patient care and vaccine safety monitoring.
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