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Post-inflammatory Pigmentary Alteration (PIPA)-Like Disorder Following COVID-19 Vaccination
Larry M Bush1,2, Priscila M Fiallo2, Maria T Vazquez-Pertejo3
1Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, USA.
Cureus
|August 4, 2025
Summary
Skin hyperpigmentation can occur after mRNA COVID-19 vaccination. This rare side effect stems from melanocyte dysfunction triggered by the vaccine
Area of Science:
- Dermatology
- Immunology
- Vaccinology
Background:
- Cutaneous manifestations are reported with SARS-CoV-2 infection and mRNA COVID-19 vaccination.
- Observed reactions include local site issues, hypersensitivity, and autoimmune responses.
- Molecular mimicry is proposed as a common immunologic mechanism.
Observation:
- A case of previously undescribed cutaneous hyperpigmentation is presented.
- This reaction occurred following immunization with an mRNA COVID-19 vaccine.
- The hyperpigmentation resulted from melanocyte dysfunction and melanin overproduction.
Findings:
- The inflammatory event of vaccination triggered secondary cutaneous hyperpigmentation.
- Melanocyte dysfunction led to melanin overproduction.
- This represents a novel vaccine-related dermatologic finding.
Implications:
- Highlights a new potential adverse skin reaction to mRNA COVID-19 vaccines.
- Suggests further investigation into vaccine-induced immune responses affecting melanocytes.
- Informs clinicians about a rare but observable post-vaccination dermatologic complication.
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