Cutaneous leukocytoclastic vasculitis following COVID-19 vaccination with Ad26.COV2.S vaccine: a case report and literature review.

ABSTRACT

Cutaneous vasculitis is a recognized and potentially serious adverse event of immunization with several vaccines, and COVID-19 vaccines are no exception. We present a case of cutaneous leukocytoclastic vasculitis occurring 17 days after inoculation with adenoviral vector vaccine (Ad26.COV2.S) in a previously healthy 30-year-old patient with no history of prior adverse events following vaccination. Transient laboratory abnormalities (mild proteinuria, cryoglobulinemia, and slightly diminished C3 complement level) were also noted, but they resolved with the resolution of skin changes after treatment with topical steroids. Although the frequency of cutaneous vasculitis after COVID-19 vaccines is extremely low, it presents an important challenge for the clinician when faced with an uncertain and delicate decision whether these patients can safely receive booster doses of COVID-19 vaccine. Because vaccination certificates are necessary for day-to-day activities and have a limited validity date, this may be an uncomfortable issue.