ADVERSE SKIN MANIFESTATIONS FOLLOWING THE ADMINISTRATION OF COVID-19 VACCINATION:REPORT OF 48 CASES

Introduction: Since the first reported case of Coronavirus 19 (COVID 19) outbreak, several vaccines have been developed in a record time and approved for distribution around the globe. The different COVID 19 vaccines showed a good safety and immunogenicity profiles in randomized controlled trial . However since the beginning of mass vaccination , dermatologistes have reported various skin reactions following the administration of Covid-19 vaccines. Materiel and method We conducted a prospective study among patients referred to the Dermatology Department at University Hospital of Marrakech, from March 2021 to february 2022 who presented with skin manifestations induced by COVID-19 vaccines. We excluded patients with immediate and/or delayed local site injection reactions as well as the patients whom the reactions couldnÂ't be linked to the COVID 19 vaccine. Data were collected and managed using a questionnaire. The data entry was done using Microsoft Excel. Results We collected 48 patients who presented cutaneous reactions after the administration of Covid 19 vaccine. We noted that 24 (50%) of the patients presented cutaneous reactions after the ChAdOx1 nCoV-19 , 23 after the BBIBP-CorV (48 %) vaccination and only one patient (2%) presented cutaneous reaction after BNT162b2 vaccine.Twenty-six of our patients were female (54.1%) and 22 were male (45.9%). The patientsÂ' mean age was 49.04years (range 12-80). Of 48 patients, 18 had chronic conditions (37.5%) . The majority of the reactions occurred after the first dose of the vaccine with thirty seven patients (77%) and 11 patients( 23%) after the second dose.The mean onset time was 7.7 days. Of the ChAdOx1 nCoV-19 vaccine (N=24), 18 reactions (75 %) appeared after the first dose and 6( 25%) after the second. Of the BBIBP-CorV (N=23) 18 reactions (78.3%) appeared after the first dose and 5 (21.7%) after the second. The only reaction noted with the BNT162b2 vaccine occured after the first dose. The most prevalent cutaneous reaction was herpes zoster in 27% of the patients,followed by lichen planus in 16.6% and urticaria in 14.6% of the cases. Hospitalization was required in 8 cases (16.7%). Of the thirty-seven patients that presented a cutaneous reaction after the first dose : twelve did not develop any cutaneous reaction after the second dose of the vaccine (32.4%), twelve refused to have the second dose(32.4%), seven patients had an exacerbation of their reaction(18.9%), three did not show up for the follow up(8.2%) , 2 patients had the exact same reaction following the second dose of the vaccine(5.4%). We noted one death in our series: it was a severe case of pemphigus vulgaris who died from a sepsis complication. Conclusion: The urge to find a new vaccines has been crucial to stop the spread of the COVID 19 infection. Dermatologist have the obligation to report on the cutaneous adverse reaction, as well as managing all the cutaneous complications of the covid 19 vaccine. Despite of all the cutaneous reactions reported in our study and in the literature, the adverse effects are rarely life threatening, and thus shouldnÂ't discourage the patient to get vaccinated.