COVID toes following vaccination.

Area of Science:

• Dermatology
• Immunology
• Vaccinology

Background:

• COVID-19 infection can cause a skin condition known as "COVID toes."
• These lesions are characterized as pernio-like, presenting with pale purple, painful, and ill-defined cyanotic areas.
• Histologic studies reveal inflammatory infiltrates within these lesions.

Purpose of the Study:

• To investigate the occurrence of COVID toes following COVID-19 vaccination.
• To analyze the characteristics and timeline of these post-vaccination cutaneous manifestations.
• To explore the potential link between COVID toes and the immune response to SARS-CoV-2.

Main Methods:

• Analysis of data reported to the Vaccine Adverse Event Reporting System (VAERS) through May 25, 2021.
• Inclusion of cases reporting "COVID toes" or similar symptoms post-vaccination.
• Demographic and clinical data extraction, including vaccine type, onset of symptoms, and severity.

Main Results:

• Twenty-nine individuals reported COVID toes after vaccination to VAERS.
• The average age of affected individuals was 52 years, with 79% being women.
• Lesions appeared approximately 4.5 days post-vaccination, often after the first dose, with some cases requiring hospitalization and one fatality.

Conclusions:

• COVID toes can be a clinical syndrome following COVID-19 vaccination, affecting individuals who received mRNA and adenovirus vector vaccines.
• The occurrence of COVID toes post-vaccination suggests it may represent an immune response rather than active viral infection.
• These findings underscore the importance of monitoring for and understanding vaccine-induced immune responses and their cutaneous manifestations.