This study aimed to evaluate if patients under biologics have a lower risk of psoriasis flares after coronavirus disease 2019 (COVID-19) vaccination than other psoriatic patients. Of 322 recently vaccinated patients admitted for psoriasis at the Dermatological Psoriasis Unit during January and February 2022, 316 (98%) had no psoriasis flares after COVID-19 vaccination (79% under biologic treatment, 21% not biologically treated) and 6 (2%) presented psoriasis flares after COVID-19 vaccination (33.3% under biologic treatment, 66.6% not biologically treated). Overall, psoriasis patients under biologic treatment, developed fewer psoriasis flares after COVID-19 vaccination (33.3%), than patients not under biologic treatment (66.6%) (p=0.0207; Fisher’s exact test).

We present the case of a 24-year-old Caucasian man, who developed a scaly erythematous skin rash after the second dose of coronavirus disease 2019 (COVID-19) vaccination with Comirnaty (BNT162b2, BioNTech/Pfizer; Pfizer, New York, NY, USA) and proved positive for Epstein-Barr virus (EBV) reactivation. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines have been associated with an up-regulated T helper type 1-cell response, possibly favoring an immune system imbalance. Also, EBV reactivation has been postulated after COVID-19 vaccination, but only in the immunosuppressed. Noteworthy we report the first case of EBV viral reactivation associated with cutaneous manifestations in an immunocompetent patient after the COVID-19 vaccine.

We present the case of a 48-year-old Caucasian woman, who developed an acute urticarial rash after the second dose of coronavirus disease 2019 (COVID-19) vaccination with Oxford-AstraZeneca. Though the most common cutaneous adverse reactions to vaccines are non-allergic, we believe the rash may represent an immediate hypersensitivity type I reaction against the vaccine excipient Polysorbate 80 (Pol80), configuring an acute allergic urticaria. Skin prick test with Pol80, were performed and resulted positive, confirming the role of Pol80 in eliciting immediate hypersensitivity in our patient. Of note, sensitizing excipients contained in COVID-19 vaccines are commonly used in everyday products and preexisting sensitizations may cause allergic reactions to vaccines, highlighting the need to undergo allergy consultation upon vaccine administration.