Pityriasis rubra pilaris triggered by vaccination

Area of Science:

• Dermatology
• Immunology
• Public Health

Background:

• Pityriasis rubra pilaris (PRP) is a rare inflammatory papulo-squamous skin disease with unknown etiopathogenesis.
• While infections are common triggers, vaccinations have been infrequently reported as potential causes.
• Understanding potential vaccine-related triggers for PRP is crucial for patient care.

Purpose of the Study:

• To systematically review documented cases of Pityriasis rubra pilaris (PRP) triggered by vaccinations.
• To analyze the characteristics and outcomes of PRP following vaccination.
• To highlight the importance of considering vaccination history in PRP diagnosis.

Main Methods:

• A systematic literature search was conducted on PubMed and Scopus for articles published between January 2000 and June 2024.
• The search focused on cases of PRP occurring post-vaccination.
• An additional unpublished case was included in the analysis.

Main Results:

• Thirty cases of post-vaccination PRP were identified from 23 articles.
• The majority of affected individuals were adult males (66.6%) with a median onset age of 55 years.
• Most cases (90%) occurred after SARS-CoV-2 vaccination, predominantly with mRNA vaccines (51.9%); 46.6% occurred after the first dose, and 66% of those re-vaccinated experienced exacerbation.
• Pediatric cases involved Measles-Mumps-Rubella and diphtheria-tetanus-pertussis vaccines.
• PRP onset typically occurred within a median of 10 days post-vaccination.
• The condition generally responded well to treatments, with only 13.3% showing no resolution.

Conclusions:

• Post-vaccination Pityriasis rubra pilaris (PRP) is rare but likely underdiagnosed.
• Recognizing the association between vaccination and PRP onset is important for identifying potential triggers.
• A comprehensive patient history, including recent vaccinations, is essential for diagnosing and managing PRP.