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Cutaneous T-Cell–Rich Lymphoid Infiltrates After SARS-CoV-2 Vaccination

Educational Objective
To identify the key insights or developments described in this article

The most common skin reactions to mRNA-based vaccination against SARS-CoV-2 have included local and delayed injection site reactions and urticaria and have been more frequently associated with the Moderna vaccine vs the Pfizer/BioNTech vaccine.1 To our knowledge, cutaneous lymphoid reactions to COVID-19 vaccination have yet to be assessed in comprehensive vaccine studies.

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Article Information

Accepted for Publication: May 2, 2022.

Published Online: July 20, 2022. doi:10.1001/jamadermatol.2022.2383

Corresponding Author: Joan Guitart, MD, Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Ste 1765, Chicago, IL 60611 (jguitart@nm.org).

Author Contributions: Ms Hooper and Dr Guitart had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Hooper, LeWitt, Guitart.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Hooper, Chung, Guitart.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Hooper.

Administrative, technical, or material support: Zhou, Guitart.

Supervision: Zhou, Guitart.

Conflict of Interest Disclosures: Dr Choi reported receiving personal fees from Kyowa Kirin outside the submitted work. Dr Guitart reported receiving personal fees from Kyowa Kirin and grants from Elorac outside the submitted work. No other disclosures were reported.

Additional Contributions: We thank the patient for granting permission to publish the photograph in the Figure. We also thank the other patients and their clinical practitioners: Janelle Manton, MD, Dermatology Associates of Glastonbury; Alicia Sigal, MD, Dermatopathology Laboratory of New England; Sarah Kasprowicz, MD, Medical Dermatology Associates of Chicago; David Barron, MD, Dermpath Diagnostics; Tanya Bhattacharya, MD, John Pujals, MD, Hannah Miller, PA-C, and Eric Hanson, MD, Forefront Dermatology; Ansley Coffey, PA-C, Savannah River Dermatology; Kristopher McKay, MD, SkinPath Solutions; Timothy Tan, DO, Consolidated Pathology Consultants; and Artem Sergeyenko, MD, SkinMD.

References
1.
Kroumpouzos  G , Paroikaki  ME , Yumeen  S , Bhargava  S , Mylonakis  E .  Cutaneous complications of mRNA and AZD1222 COVID-19 vaccines: a worldwide review.   Microorganisms. 2022;10(3):624. doi:10.3390/microorganisms10030624 PubMedGoogle ScholarCrossref
2.
LeWitt  T , Chung  C , Manton  J ,  et al.  Rare lymphomatoid reactions following SARS-CoV-2 vaccination.   JAAD Case Rep. 2022;20:26-30. doi:10.1016/j.jdcr.2021.11.021 PubMedGoogle ScholarCrossref
3.
Brumfiel  CM , Patel  MH , DiCaudo  DJ , Rosenthal  AC , Pittelkow  MR , Mangold  AR .  Recurrence of primary cutaneous CD30-positive lymphoproliferative disorder following COVID-19 vaccination.   Leuk Lymphoma. 2021;62(10):2554-2555. doi:10.1080/10428194.2021.1924371 PubMedGoogle ScholarCrossref
4.
Mintoff  D , Scerri  L , Betts  A .  SARS-CoV-2 mRNA vaccine injection site pseudolymphoma.   J Eur Acad Dermatol Venereol. 2022;36(1):e20-e22. doi:10.1111/jdv.17680 PubMedGoogle ScholarCrossref
5.
Chung  YH , Beiss  V , Fiering  SN , Steinmetz  NF .  COVID-19 vaccine frontrunners and their nanotechnology design.   ACS Nano. 2020;14(10):12522-12537. doi:10.1021/acsnano.0c07197 PubMedGoogle ScholarCrossref
6.
Cerroni  L , Borroni  RG , Massone  C , Chott  A , Kerl  H .  Cutaneous B-cell pseudolymphoma at the site of vaccination.   Am J Dermatopathol. 2007;29(6):538-542. doi:10.1097/DAD.0b013e3181591bea PubMedGoogle ScholarCrossref
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