Generalized morphea induced by the COVID-19 vaccine in a patient with chronic urticaria

Adverse events following vaccinations have been noted for centuries, but as of recently, discussions concerning these adverse effects have increased due to the COVID-19 pandemic and the consequent delivery of vaccinations. Through presenting new cases of such adverse events and reviewing the literature, we aim to facilitate the recognition of COVID-19 vaccine-induced autoimmune diseases that may occur in the years after the pandemic has been contained. We report on a case of biopsy-proven morphea after the COVID-19 vaccine, in which case the patient developed diffuse skin lesions all over her body. The patient was known to have chronic urticaria and received two doses of the Pfizer-BioNTech COVID-19 vaccines (BioNTech, Fosun Pharma, Pfizer, New York City, USA). The patient started to notice itchy lesions on her arms two months after taking her second dose of the vaccine. This is the first case reported of generalized morphea following COVID-19 vaccination with another autoimmune disease and represents the first case of generalized morphea reported in the Middle East.