Age: 60.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Granuloma annulare, Injection site rash, Rash, Stress
Clinical narrative: At the time of the vaccination, no adverse affects. I got the first dose in my left arm (due to being at a drive-thru site). Barely any soreness at all (discomfort 1/10). I sleep on that side, so I asked for dose #2 in my right arm. It was exactly three weeks later. No side effects, no fever, no nausea, hardly felt it at the injection site. Not much discomfort (scale 3/10 in my arm).  After almost 2-3 weeks, started to see a rash, which got more extensive and was later diagnosed via biopsy as being: Granuloma annulare. The rash started on my upper arms, near the vaccine site and has spread quite a bit.  SEE CONTINUATION PAGE for a full history of this issue and what has been tried to date..... The rash started on my upper arms, near the vaccine site and now covers both arms, is also on both legs, my chest and neck.   __The rash started about 2-3 weeks after my second dose of Pfizer. I thought it was stress, as I was retiring on 5/8, in just another 2 weeks.... This assumption that it was stress caused me to delay seeing my doctor (my mother used to break out in hives from stress, regularly). At that time, it was mostly on my upper arms - heavily on the outer side and some spots on the inner side, and starting on the backs of my calves with a few spots on the front of my thighs. __I finally saw my doctor on 5/17 when I was clear that it needed to be seen. Doctor thought it was a histamine reaction to something. But I had not changed ANYTHING in my diet, no new/different soaps, no new clothes, no new sheets, we could not identify anything different that could have caused an allergic reaction. Doctor started me on OTC at first: benadryl cream and claritin 1x/day, with instructions to come back in two weeks. This regimen did not help and the rash got worse. __Second office visit with Doctor  on 6/3:  we tried a different regimen, adding a prescription ointment: Triamcinolone Acetonide Topical, and  upping the OTC antihistamines. Claritin in AM and Zyrtec in PM. (since they had different ingredients). Still didn't clear it up at all. Instead, it was spreading down my arms and more on my legs. __Office visit #3 to Doctor  on 6/14: Since treating it like a histamine reaction was not having any effect, he took a biopsy so we could definitely know what it was. Got the results 6/22. Doctor  prescribed a steroid cream, with instructions 2 weeks on/2 weeks off. I used this for two weeks, results were not great..... I then found a medical dermatologist who was familiar with my diagnosis.  __7/13: Met with Physician Assistant at Dermatologist.  He was very familiar with Granuloma annulare. We went with a cream and a steroid pill:  Prednisone - 20 mg/day for 10 days then reduce to 10 mg/day for 10 days. And Pimecrolimus Cream 1% (generic for Elidel Cream 1%). Instructed to apply cream 2x/day. Ran out pretty quickly, as the rash was extensive on my arms and legs.  __8/3: Visit #2 with Physician Assistant. Rash seemed better. Was less red and smoother to the touch. Renewed prescription for Prednisone (waited until 8/16 to take the next round, due to a trip and wanting to put some time between steroid treatments).  Used the cream at least once daily, sometimes twice. Found it difficult to plan when to apply it, due to wanting to avoid being "slimy" around other people or sitting on furniture or handling my contact lenses.  __My own assessment is that the Prednisone does not make a big difference for the rash. But the cream does - though only if I apply it heavily and frequently. If I miss a few applications, then the rash gets visibly worse, and quickly. The rash is now also on my upper chest and I can feel the bumpiness on sides and back of my neck. It is much worse on my lower arms - both outside and inside, as well as the inside of my upper arms. It has also spread on my legs. The back of my calves are much worse, it is now behind my knees and starting up the back of my thigh. And on the front of the thighs it has spread upwards and to the inside. Also, on my left foot, there was one small spot in the middle of my arch (on the top of the foot). That spot is now larger and there is a second spot closer to my ankle.  __I will make another appointment with the Dermatologist. I am despondent at how bad I look, that I cannot get massages and cannot spend much time outside to go hiking (the cream says to avoid contact with eyes and avoid direct sunlight). "Medical search" says that Granuloma annulare will clear up on its own but may take a couple YEARS to clear up. I don't know how I can hang in there that long. We are retired and both fully vaccinated and wanting to start traveling. But I can't....looking like this.   I have never had any reaction to a vaccination, ever, other than the normal expected discomfort as the vaccine does its job creating antibodies. I had my Shingles vaccine (#1 10/15/19 and #2 on 3/11/20), more than a year before this vaccine. And I get my flu shot every year, last one was 10/16/20.