Dear Editor,
Unspecific inflammatory cutaneous reactions are an expected finding in course of vaccinations as a broad cytokine release orchestrates the activation of both cellular and humoral components of the immune system.1 Due to an interferon-γ driven pathogenesis, exacerbation and new onset of cutaneous lupus erythematosus (CLE) have been described in course of influenza- and DPT (diphtheria, pertussis, and tetanus) combination vaccines.2, 3 Most clinical trials of different coronavirus disease 2019 (covid-19) vaccines did not include rheumatic patients; disease worsening was expected in interferonopathies and systemic lupus erythematosus from a pathophysiological point of view.4 Very recently, an Italian group published first experiences with cutaneous adverse reactions due to a messenger ribonucleic acid (mRNA)-based covid-19 vaccine, which included erythema, swelling and generalized erythematous rash including urticaria.5 We here present a case of a subacute CLE (SCLE) patient, who developed a disease exacerbation after receiving the first dose of BNT162b2 (Comirnaty, BioNTech/Pfizer), but tolerated the second dose without symptoms.
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