Mucocutaneous adverse effects following COVID-19 vaccination: a case series with a comprehensive review of the literature

Since coronavirus disease 2019 (COVID-19) vaccines were approved without long-term monitoring, tracking their adverse effects appears to be necessary. Mucocutaneous adverse events are of great importance due to their visibility and the potential effect on inducing fear in patients leading to vaccine hesitancy. We searched PubMed, Google Scholar, and Scopus in this regard, and all of the relevant papers published until June 28, 2021, were included if we could access their full texts. Moreover, we included some of our cases from Iran. We found various mucocutaneous manifestations after COVID-19 vaccination, including local injection site reactions (acute or delayed), urticarial lesions, pityriasis rosea-like rashes, angioedema, morbilliform rashes, pernio-like lesions, acrocyanosis, petechial/ purpuric/ecchymotic lesions, herpes flare-up, herpetiform rashes, oral erosive lesions, acral pustular rashes, erythema multiform, dermographism, herpes zoster, generalized pruritus, contact dermatitis, reaction to dermal fillers and non-specific rashes. We categorized them by their time of initiation (acute or delayed) and site of involvement (local injection site, remote area, or generalized). Delayed local reactions, local injection site reactions, urticarial lesions, and pityriasis rosea-like and morbilliform rashes were among the most common cutaneous adverse events. Dermatologists should be aware of these potential reactions to manage them properly, reassure patients, and encourage them to continue their vaccination.