Table 1.
Demographic, clinical, histological and immunological characteristics of post SARS-Cov-2 vaccination AIBDs patients.
|
Pemphigus Vulgaris | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Author | Patient | Age | Sex | Bullous Lesion localization | Vaccine | 1st, 2nd, 3rd dose | 2nd dose | Time-to-onset (days) | Histopathology | DIF/IFF | DSG1/DSG3 | Treatment | Outcome |
| Thongprasom K et al 2021 | 1 | 38 | F | Oral mucosa | AstraZeneca | 1st | NA | 7 | Histopathological features in keeping with a diagnosis of pemphigus (no better specified) | DIF in keeping with a diagnosis of pemphigus (no better specified) | NA | TC | Complete clinical resolution after 1 week |
| Solimani F et al 2021 | 2 | 40 | F | Oral mucosa, trunk and back | Pfizer | 1st | Given, lesions worsened | 5 | Subrabasal acantholysis | DIF: IgG intercellular deposition | +/+ | OC/AZ | Ongoing |
| Koutlas IJ 2021 | 3 | 60 | M | Oral mucosa | Moderna | 2nd | / | 7 | Suprabasal acantholysis | DIF: IgG/C3 intercellular deposition IIF: IgG intercellular pattern |
-/- | OC/RTX | Complete clinical resolution after 5.5 months |
| Knechtl GV et al 2021 | 4 | 89 | M | Oral mucosa, trunk, back, left arm | Pfizer | 2nd | / | 30 | Suprabasal acantholysis | DIF: IgG intercellular deposition | +/+ | OC/RTX | Control of disease after 10 weeks |
| Akoglu G et al 2022 | 5 | 69 | F | Oral mucosa, scalp, trunk, limbs | CoronaVac | 1st | NA | 7 | NA | NA | +/+ | MTX | Control of the diseases in 2 weeks, almost complete remission after 12 weeks |
| Our case | 6 | 60 | F | Oral mucosa, oropharynx mucosa | Pfizer | 2nd | / | 7 | Suprabasal acantholysis | DIF: IgG intercellular deposition | -/+ | OC/RTX | Improving at week 8 |
| Pemphigus Foliaceus | |||||||||||||
| Lua ACY et al 2021 | 1 | 83 | M | Face, scalp, trunk, limbs | Pfizer | 2nd | / | 2 | Subacute spongiotic dermatitis with dermal eosinophils and plasma cells | DIF: C3 at the DEJ and intercellular bridges within the epidermis. IIF: Intercellular pattern |
+/- | OC | Good clinical response (no better specified) |
| Bullous Pemphigoid | |||||||||||||
| Author | Patient | Age | Sex | Bullous Lesion localization | Vaccine | 1st, 2nd, 3rd dose | 2nd dose | Time-to-onset (days) | Histopathology | DIF/IIF | BP180/BP230 | Therapy | Outcome |
| Pauluzzi M et al 2021 | 1 | 46 | M | Trunk, arms | Pfizer | 1st | Not given | 15 | Subepidermal split | DIF: C3 at the BMZ | +/- | OC/AZ | Ongoing at week 7 |
| Agharbi FZ et al 2021 | 2 | 77 | M | Scalp, trunk, limbs | AstraZeneca | 1st | Not given | 1 | Subepidermal split | DIF: IgG at the BMZ IIF: IgG at the BMZ |
NA | TC/DC | Favorable outcome (no better specified) |
| Young J et al 2021 | 3 | 68 | M | Oral mucosa, trunk | Pfizer | 1st | Given, lesions worsened | 3 | Subepidermal split with infiltrate composed of eosinophils and hemosiderophages. | DIF: IgG/C3 at the BMZ | NA | TC | Resolution after 3 months |
| Gambichler T 2021 | 4 | 80 | M | Trunk, legs | Pfizer | 1st | Given, lesions worsened | 7 | Subepidermal split | DIF: IgG/C3 at the BMZ IIF: IgG at the BMZ |
+/+ | OC | NA |
| 5 | 89 | M | Entire integument | Pfizer | 1st | NA | 2 | Subepidermal split | DIF: IgG/C3 at the BMZ IIF: IgG at the BMZ |
+/+ | OC | NA | |
| Pérez-Lòpez I et al 2021 | 6 | 78 | F | Face, trunk, limbs | Pfizer | 1st | Given, lesions reactivated | 3 | Subepidermal split | DIF and IIF positive (no better specified). | NA | OC | Good clinical response (no better specified) |
| Nakamura K et al 2021 | 7 | 83 | F | All the body surfaces involved | Pfizer | 2nd | / | 3 | Subepidermal split, infiltrate with eosinophils | DIF: IgG at the BMZ | +/- | OC/IVIg | NA |
| Tomayko MM et al 2021 | 8 | 97 | F | NA | Pfizer | 2nd | / | 2 | Subepidermal split, infiltrate with eosinophils | DIF: IgG/C3/IgA | +/+ | TC/DC/NI | Improving at week 2 |
| 9 | 75 | M | NA | Pfizer | 2nd | / | 10 | Subepidermal split, infiltrate with eosinophils | DIF: C3 | +/NA | TC/OC/DC/NI | Improving at week 3 | |
| 10 | 64 | M | NA | Pfizer | 2nd | / | 14 | Subepidermal split, infiltrate with eosinophils | DIF: C3 | +/+ | TC | Improving at week 4 | |
| 11 | 82 | M | NA | Pfizer | 2nd | / | 1 | Subepidermal split, infiltrate with eosinophils | DIF: IgG/C3/week IgA at the BMZ | -/- | TC | Resolved at week 2 | |
| 12 | 95 | F | NA | Pfizer | 1st | Given, no lesion reactivation | 5 | Subepidermal split, infiltrate with eosinophils | DIF: IgG/C3/week IgA at the BMZ | -/- | TC/DC/NI | Resolved at week 8 | |
| 13 | 87 | M | NA | Moderna | 2nd | / | 21 | Subepidermal split, infiltrate with eosinophils | DIF: C3 at the BMZ | +/+ | OC/DC/NI | Ongoing after 105 days | |
| 14 | 42 | F | NA | Moderna | 2nd | / | 3 | Subepidermal split, infiltrate with eosinophils | DIF: IgG/C3/weak granular IgM at the BMZ | +/+ | IMC/TC/IVC | Ongoing at day 23 | |
| 15 | 85 | M | NA | Pfizer | 1st | Not given | 5 | Subepidermal split, infiltrate with eosinophils | DIF: IgG/C3 at the BMZ | NA | OC | Ongoing at day 59 | |
| Bostan E et al 2021 | 16 | 67 | M | Oral mucosa, trunk, arms | Inactivated Covid-19 vaccine (no better specified) | 1st | Given, no lesion reactivation | 35 | Subepidermal split, mixed infiltrate rich in eosinophils | DIF: IgG/C3 at the BMZ | NA | OC/OM | Considerable response but without full recovery after 8 months from the second vaccine dose |
| Schmidt V et al 2021 | 17 | 84 | F | Trunk, back, arms, legs | Moderna | 1st | Given, lesions worsened | Few days (no better specified) | Subepidermal split, spongiosis and infiltrate with eosinophils | NA | +/+ | NA | NA |
| Coto-Segura P et al 2021 | 18 | 85 | M | Trunk, arms | Pfizer | 2nd | / | 8 | Subepidermal split, infiltrate with eosinophils | DIF: IgG/C3 at the BMZ | NA | TC/OC | In resolution |
| 19 | 84 | M | Trunk arms | Pfizer | 2nd | / | 7 | Subepidermal split, infiltrate with eosinophils | DIF: IgG/IgM/C3 at the BMZ | NA | TC/OC | In resolution | |
| Larson V et al 2021 | 20 | 76 | M | Legs | Pfizer | 1st | Given, lesions worsened | 21 | Subepidermal split, infiltrate with eosinophils | DIF: IgG/C3 at the BMZ | NA | TC/OC/DC/NI | Improvement |
| 21 | 84 | M | Legs | Moderna | 2nd | / | 14 | Intraepidermal spongiotic vesicles and eosinophilic spongiosis | DIF: IgG/C3 at the BMZ | NA | TC/OC | Improvement | |
| Hung WK et al 2022 | 22 | 39 | M | Trunk, hands, feet | Moderna | 1st | Not specified | 30 | Subepidermal split, infiltrate with eosinophils | DIF: IgG/C3 at the BMZ IIF: positive titer of 1: 40 for anti-basement membrane zone antibodies. |
NA | IVC/OC/DC | Resolution |
| Afacan E et al 2022 | 23 | 88 | F | NA | CoronaVac | 2nd | / | 30 | Subepidermal split | DIF positive (no better specified) | NA | TC/OC/MTX | NA |
| 24 | 82 | F | NA | Pfizer | 3rd | / | 14 | Subepidermal split | DIF positive (no better specified) | NA | TC/OC/DA | Improvement | |
| 25 | 65 | M | NA | Pfizer | 3rd | / | 14 | Subepidermal split | DIF positive (no better specified) | NA | TC/DC | Improvement | |
| 26 | 82 | F | NA | CoronaVac | 2nd | / | 14 | Subepidermal split | DIF positive (no better specified) | NA | TC/DC | Improvement | |
| Linear IgA disease | |||||||||||||
| Author | Patient | Age | Sex | Bullous Lesion localization | Vaccine | 1st, 2nd, 3rd dose | 2nd dose | Time-to-onset (days) | Histopathology | DIF/IFF | BP180/BP230 DSG1/DSG3 | Therapy | Outcome |
| Hali et al 2021 | 1 | 61 | M | Oral mucosa, genital mucosa, trunk, legs | AstraZeneca | 2nd | / | 3 | Subepidermal split with an inflammatory infiltrate composed of lymphocytes, histiocytes and some eosinophilic polynuclear lymphocytes | DIF: IgA at the BMZ IIF: IgA at the BMZ |
-/- -/- |
OC | Clinical improvement (no better specified) |
| Coto-Segura P et al 2021 | 2 | 71 | M | Legs | Pfizer | 2nd | / | 3 | Subepidermal split, infiltrate with eosinophils | DIF: IgA at the BMZ | NA | TC | In resolution |
AIBDs= autoimmune blistering diseases; AZ= Azathioprine; BMZ: basement membrane zone; DA: dapsone; DC= Doxycycline; DIF= direct immunofluorescence; DSG1= antibody anti-desmogleiin 1; DSG3= antibody anti-desmoglein 3; IIF= indirect immunofluorescence; IMC= intramuscular corticosteroids; IVC= intravenous corticosteroids; IVIg= intravenous immunoglobulins; MO=mupirocin ointment; MTX: methotrexate; NA= Not available; NI=nicotinamide; OC= oral corticosteroids, OM= omalizumab; RTX= rituximab; TC= topical corticosteroids.