Herpes zoster following COVID-19 vaccination: about 2 cases

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Abstract

The COVID-19 vaccine often well tolerated in healthy adults at the same time, different cutaneous reactions have been reported. Two cases presented of developed a first episode of Herpes zoster (HZ) following the first dose of vaccination against COVID-19. The pathogenetic mechanism suggested that SARS-CoV-2 infection can induce a decrease of blood absolute lymphocyte number, especially CD3+ CD8+ lymphocyte. The COVID-19 vaccine, by stimulation of inflammatory cytokines, may negatively affect the antigen expression and contribute to HZ reactivation. It is also possible that the vaccine induces some kind of immunomodulation that allows VZV to revert an infectious state.

About the authors

Nesrine Ben Salah

University of Monastir, Department of Dermatology

Author for correspondence.
Email: nesrinebensalah2612019@gmail.com
Tunisia, Fattouma Bourguiba Hospital Avenue Avicenne — Monastir — 5019

Ines Lahouel

University of Monastir, Department of Dermatology

Email: nesrinebensalah2612019@gmail.com
Tunisia, Fattouma Bourguiba Hospital Avenue Avicenne — Monastir — 5019

Linda Manaa

University of Monastir, Department of Dermatology

Email: nesrinebensalah2612019@gmail.com
Tunisia, Fattouma Bourguiba Hospital Avenue Avicenne — Monastir — 5019

Yosra Soua

University of Monastir, Department of Dermatology

Email: nesrinebensalah2612019@gmail.com
Tunisia, Fattouma Bourguiba Hospital Avenue Avicenne — Monastir — 5019

Monia Youssef

University of Monastir, Department of Dermatology

Email: nesrinebensalah2612019@gmail.com
Tunisia, Fattouma Bourguiba Hospital Avenue Avicenne — Monastir — 5019

Hichem Belhadjali

University of Monastir, Department of Dermatology

Email: nesrinebensalah2612019@gmail.com
Tunisia, Fattouma Bourguiba Hospital Avenue Avicenne — Monastir — 5019

Jameleddine Zili

University of Monastir, Department of Dermatology

Email: nesrinebensalah2612019@gmail.com
Tunisia, Fattouma Bourguiba Hospital Avenue Avicenne — Monastir — 5019

References

  1. McMahon DE, Amerson E, Rosenbach M, Lipoff JB, Moustafa D, Tyagi A, et al. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases. J Am Acad Dermatol. 2021;85(1):46–55. doi: 10.1016/j.jaad.2021.03.092
  2. Gershon AA, Gershon MD, Breuer J, Levin MJ, Oaklander AL, Griffiths PD. Advances in the understanding of the pathogenesis and epidemiology of herpes zoster. J Clin Virol. 2010;48 Suppl 1(Suppl 1):S2-7. doi: 10.1016/S1386-6532(10)70002-0
  3. Rodríguez-Jiménez P, Chicharro P, Cabrera LM, Seguí M, Morales-Caballero Á, Llamas-Velasco M, et al. Varicella-zoster virus reactivation after SARS-CoV-2 BNT162b2 mRNA vaccination: Report of 5 cases. JAAD Case Rep. 2021;12:58–59. doi: 10.1016/j.jdcr.2021.04.014
  4. Tartari F, Spadotto A, Zengarini C, Zanoni R, Guglielmo A, Adorno A, Valzania C, Pileri A. Herpes zoster in COVID-19-positive patients. Int J Dermatol. 2020;59(8):1028-1029. doi: 10.1111/ijd.15001
  5. Furer V, Zisman D, Kibari A, Rimar D, Paran Y, Elkayam O. Herpes zoster following BNT162b2 mRNA COVID-19 vaccination in patients with autoimmune inflammatory rheumatic diseases: a case series. Rheumatology (Oxford). 2021;60(SI):SI90-SI95. doi: 10.1093/rheumatology/keab345

Supplementary files

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2. Fig. 1. Typical Herpes Zoster rash appeared at the distribution of T6 dermatome

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3. Fig. 2. (A, B): Grouped vesicles on an erythematous base on the lower abdomen

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Copyright (c) 2022 Ben Salah N., Lahouel I., Manaa L., Soua Y., Youssef M., Belhadjali H., Zili J.

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