Chilblain lesions after COVID‐19 mRNA vaccine
Alessandro Pileri, Alba Guglielmo, Beatrice Raone, Annalisa Patrizi
Abstract
DEAR EDITOR, A 42-year-old man developed nonpainful erythematous-to-purplish patches located on his distal phalanges and nail beds (Figure ) after the first dose of the anti-COVID-19 vaccine (+ 12 days, Pfizer-BioNTech COVID-19, BNT162b2) along with an acrocyanosis of the hands. Although negative antibodies do not preclude a previous exposure to the virus, blood and swab tests were negative for COVID-19 infection and thrombophilic/autoimmune conditions. After the second jab (+ 21 days) no worsening of the lesions or other onset of symptoms were observed. A diagnosis of possible severe adverse event due to vaccine administration was made. 1 Chilblain lesions have been described in patients with COVID-19 and may be due to an abnormal inflammatory response. Although not reported in clinical trials, 2 vaccination may have promoted an immunological reaction leading to vascular swelling and perniosis similar to what has been observed after COVID-19 infection.