![]() ![]() Of note, three (60%) patients received systemic biologic treatment before vaccination. Four patients (80%) had a known history of psoriasis and 3 (60%) had concomitant psoriatic arthritis (PsA). The mean age (SD) at presentation was 51.8 (10.4) years. Before the consultation, all patients were free of clinical COVID-19-specific symptoms and were tested negative for COVID-19 infection by PCR. The current case series comprises five patients that presented at our department with new onset or exacerbation of psoriasis, following COVID-19 vaccination, of whom 2 (40%) were women and 3 (60%) were men. Specifically, we aim to elucidate latency from vaccination to manifestation of clinical worsening, a dose of vaccination, and clinical features. Thus, we aim to add further insight into COVID-19 vaccine-related characteristics of psoriasis patients that presented with a COVID-19 vaccine-induced exacerbation. However, current knowledge on features of COVID-19 vaccine-induced psoriasis worsening is inconsistent and remains to be firmly established. Recently, several cases of psoriasis exacerbation (as measured by an increased PASI and/or BSA score), preceded by COVID-19 vaccination emerged ( 4– 6). To control the current COVID-19 pandemic, respective vaccinations are being carried out worldwide. Vaccine-related onset or exacerbations of psoriasis in patients with precipitated influenza or tetanus-diphtheria vaccination have been described ( 2, 3). Psoriasis is a chronic, immune-mediated inflammatory skin disease that may be induced by both local factors, also known as the Koebner phenomenon, and systemic triggers, i.e., streptococcal infections ( 1). This underscores that the benefits of COVID-19 vaccination far outweigh the risks, as also in patients with psoriasis. ![]() Hence, the underlying inflammatory response is most likely the culprit agent triggering psoriasis. New onset and exacerbation of psoriasis have also been noted following COVID-19 infections. ![]() In most cases, psoriatic lesions almost cleared after applying topical steroids in addition to current treatment, while one patient with psoriatic arthritis required systemic treatment. The clinical impact with a mean PASI increase following COVID-19 vaccination of 7.2 (5.6) was considered relevant. The mean latency from the day of vaccination was 7.2 (1.8) days (SD). In most patients, exacerbation or new onset occurred after the 2nd or 3rd vaccination. In our cohort, one patient experienced the new onset of psoriasis, while four had an exacerbation following COVID-19 vaccination. To add to the understanding of COVID-19 vaccination-triggered psoriasis, we report five cases with exacerbation or new-onset of psoriasis. Further, clinical- and vaccine-related features and characteristics are partly inconsistent and remain to be elucidated. Underlying immune pathogenesis is unclear and different mechanisms are assumed. Recently, COVID-19 vaccination-induced exacerbation or new-onset of psoriasis have been reported. 6Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany. ![]()
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