Urticarial vasculitis after COVID‐19 vaccination: A case report and literature review
Abstract
Dear Editor, Reports of diverse clinical adverse events following COVID-19 vaccination are increasing. The autoimmune disorder urticarial vasculitis (UV) may be caused by drugs, malignancy, other autoimmune diseases, and infections. And it has recently been associated with COVID-19 vaccination. A 68-year-old man presented to a local doctor with multiple, reddish, elevated, itchy-lesions that appeared 4 days after his third dose of Pfizer-BioNTech COVID-19 vaccine. He reported no reactions to the first two doses. Since treatment with 15 mg prednisolone (PSL) yielded no improvement, he was referred to our clinic. His medical history included angina pectoris, diabetes mellitus, dyslipidemia, and no recent drug changes. His body temperature was 37.8 C. Physical examination revealed edematous erythema with pigmentation and purpura scattered on his trunk, extremities, and thighs (Figure 1A, B). Oral mucosa was normal. Although he reported discomfort in the throat, no laryngeal edema or upper respiratory tract symptoms were evident. Laboratory results included elevated C-reactive protein (10.04 mg/dl), leukocytes (9400 cells/mm), neutrophil fraction (89.2%), and platelet, eosinophil granulocyte, C3, C4, and ANA all within normal range. Quantitative antigen test for COVID-19 was negative. Histopathological examination showed perivascular and interstitial cell infiltration. (Figure 1C). High-power view showed infiltration of neutrophils throughout the dermis. Leukocytoclastic…
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