Disseminated cutaneous herpes simplex infection after COVID-19 vaccination in a rheumatoid arthritis patient: a case report and review

• Published in: Reumatismo Vol. 74; no. 2
• Main Authors: Mohamadzadeh, D., Assar, S., Pournazari, M., Soufivand, P., Danaei, S.
• Format: Journal Article
• Language: English
• Published: PAGEPress Publications 13.09.2022
• Subjects: autoimmune disorder; COVID-19 vaccination; herpes simplex; rheumatologic disorder
• ISSN: 0048-7449; 2240-2683
• DOI: 10.4081/reumatismo.2022.1489

Since COVID-19 vaccination started in December 2020, different side effects were reported. This case report describes the possibility of developing disseminated herpes simplex infection after COVID-19 vaccine in a patient with rheumatoid arthritis. In this case report, we describe a 63-year-old Iranian female. She was a known case of seronegative rheumatoid arthritis and presented with generalized papulo-pustular itchy and painful skin lesions which appeared about seven days after the second dose of Sinopharm BIBP COVID-19 vaccine (BIBP-CorV). A biopsy of the skin lesions revealed acantholysis, neutrophils, and enlarged keratinocytes with eosinophilic intra-nuclear inclusions. Findings were consistent with herpes simplex infection. She was successfully treated by acyclovir. Disseminated cutaneous herpes simplex infection may have been triggered by COVID-19 vaccination. Reactivation of herpes virus after COVID-19 vaccines was reported in both rheumatic patients and other individuals. Whether having an underlying autoimmune inflammatory disorder could be an additional risk factor is still unknown.