Pemphigus Foliaceus after COVID-19 Vaccination: A Report of Two Cases

Table 1

Known case report(s) of pemphigus foliaceus after COVID-19 vaccination (including our 2 cases).

Authors (country)	Num. of case (s)	Age/sex of patient (s)	Vaccine regimen	Onset milestones	Concomitant drugs	Histopathology (DIF)	Treatment (s) (response)
Our cases (Vietnam)	2	53/female	Mixed 1 AZD1222 dose following 3 BBIBP-CorV doses	3 weeks following 4^th AZD1222 dose in the mixed regimen	Amlodipine	Acantholysis above the stratum basalis, dermal lymphocyte, and neutrophil infiltration (intraepidermal IgG and C3)	Corticosteroid, rituximab (almost complete response in 3 weeks)
		30/female	2 doses of mRNA-1273	2 months following 2^nd mRNA-1273 dose	None	Acantholysis above the stratum basalis (intraepidermal IgG and C3)	Topical and systemic corticosteroid (almost complete response in 4 weeks)
Pourani et al. [5] (Iran)	1	75/male	3 doses of BBIBP-CorV	2 weeks after 3^rd dose	None	Superficial epidermal bullae, mild spongiosis, superficial dermal perivascular inflammation (intraepidermal IgG and C3)	Topical corticosteroid, rituximab (significant response in 4 weeks)
Lua et al. [6] (Singapore)	1	83/male	2 doses of BNT162b2	2 days after 2^nd dose	N/A	Subacute spongiotic dermatitis (C3 dermal-epidermal junction and intercellular deposition)	Prednisolone (good clinical response)
Corrá et al. [7] (Italy)	2	80/male	3 doses of BNT162b2	17 days after 3rd dose	Amiloride, hydrochlorothiazide, esomeprazole	Subcorneal acantholysis with neutrophilic infiltration within the blister (PT1: negative; PT2: intercellular IgG deposits)	Oral corticosteroid, rituximab, MMF (probably good clinical response)
		66/female	2 doses of BNT162b2	4 weeks after 2nd dose	Rabeprazole, ticlopidine, atorvastatin, amlodipine, hydrochlorothiazide
Hali et al. [8] (Morocco)	1	50/female	2 doses of BNT162b2	15 days after 2^nd dose	None	Superficial epidermal blistering process, intact basal layer, intraepidermal eosinophils (intracellular IgG and C3)	Oral corticosteroid (complete response in 3 weeks)
Yıldırıcı et al. [9] (Turkey)	1	65/male	2 doses of BNT162b2 (6 weeks apart)	1 months after 1^st dose; 2 weeks after 2^nd dose	Nebivolol, valsartan‐hydrochlorothiazide	Intraepidermal acantholytic blister, abundant neutrophils, and scarce eosinophils (intercellular IgG and C3)	Oral corticosteroid, azathioprine (marked response in 2 weeks)