TABLE 1.
Demographics and clinical features of reported cases
| Case | Age/sex | Type of pemphigus | Latency | COVID‐19 vaccine before the clinical onset | Previous COVID‐19 vaccination | COVID‐19 vaccine after the clinical onset | Anamnesis | Concomitant medication | Treatments |
|---|---|---|---|---|---|---|---|---|---|
| 1 | 61/woman | PV | 3 d | mRNA BNT162b2 (COVID‐19 vaccine booster dose) | Two doses of mRNA‐1273 (well tolerated) | None | Arterial hypertension, undifferentiated connective tissue disease | Prednisone, acetylsalicylic acid, amlodipine, methotrexate |
Prednisone 25 mg/d for 4 wk then slowly tapered to 6.25 mg/d in 17 wk Current treatment: prednisone 6.25 mg/d |
| 2 | 80/man | PF | 17 d | mRNA BNT162b2 (COVID‐19 vaccine booster dose) | Two doses of mRNA BNT162b2 (well tolerated) | None | Arterial hypertension, gastroesophageal reflux | Amiloride, hydrochlorothiazide, esomeprazole |
Prednisone 50 mg/d for 2 wk, then tapered to 31.5 mg/d in 9 wk Following the lack of improvement, a cycle of rituximab was administered (two doses of 1 g each 15 d apart). Three weeks later, mycophenolate was added Current treatment: mycophenolate 2 gr/d and prednisone 12.5 mg/d |
| 3 | 66/woman | PF | 4 wk | mRNA BNT162b2 (second dose COVID‐19 vaccine) | One dose of mRNA BNT162b2 (well tolerated) | mRNA BNT162b2 (without clinical worsening) | Arterial hypertension, chronic coronary artery disease, gastroesophageal reflux, hypercholesterolemia | Rabeprazole, ticlopidine, atorvastatin, amlodipine, hydrochlorothiazide |
Prednisone 43.75 mg/d for 2 wk, then slowly tapered to 5 mg/d in 13 wk Because of clinical worsening, mycophenolate was added but discontinued after only 2 wk for secondary effects. Thus, prednisone was increased to 10 mg/d, then tapered to 5 mg/d in 8 wk Current treatment: prednisone 5 mg/d |
| 4 | 73/woman | PV | 4 wk | mRNA BNT162b2 (COVID‐19 vaccine booster dose) | Two doses of mRNA BNT162b2 (well tolerated) | None | Osteoporosis, major depression | Alendronate, vitamin D supplementation, haloperidol |
Prednisone 37.5 mg/d for 3 wk, then 25 mg/d for 5 wk. Rituximab (two infusion of 1 g each separated by 15 d) was added and prednisone was increased to 37.5 mg/d again Current treatment: prednisone 18.5 mg/d |
| 5 | 63/woman | PV | 4 wk | Vaxzevria (ChAdOx1) nCoV‐19 vaccine (first dose) | None | Vaxzevria (ChAdOx1) nCoV‐19 (with clinical worsening) | Arterial hypertension | Zofenopril, hydrochlorothiazide, pantoprazole | Treatment with prednisone 1 mg/kg per d was started along with a total of 2 g of rituximab injection, with rapid improvement of mucocutaneous lesions and partial remission in 8 wk |
Abbreviations: COVID‐19, coronavirus disease 2019; mRNA, messenger RNA; PF, pemphigus foliaceous; PV, pemphigus vulgaris.