Sex: F
Vaccine: COVID19
Symptoms: Emergency care examination, Erythema multiforme, Physical examination, SARS-CoV-2 test
Clinical narrative: Erythema multiforme; This is a literature report.  A 21-year-old female patient received BNT162b2 (BNT162B2), as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Bnt162b2 (DOSE 1, SINGLE), for covid-19 immunization, reaction(s): "uneventful". The following information was reported: ERYTHEMA MULTIFORME (medically significant), 3 days after the suspect product(s) administration, outcome "recovered". The event "erythema multiforme" required emergency room visit. The patient underwent the following laboratory tests and procedures: Emergency care examination: Presumed to have a viral or bacterial infection; Physical examination: revealed generalized targetoid lesions on the notes: extremities, including the palms and soles, with rare lesions on the trunk. There was no mucosal or nail involvement; SARS-CoV-2 test: negative, notes: before and after the eruption. Therapeutic measures were taken as a result of erythema multiforme. Clinical Course: A 21-yeareold woman with no past medical history presented with severe itching and a rash that started on the hands and feet and spread to the extremities 3 days after the second dose of BNT162b2 COVID-19 vaccine. It was accompanied by swelling of her hands and feet and some joint discomfort. The patient denied having a history of allergies, HSV infection, or new medications. The course after the first dose of vaccine was uneventful, and the patient reported multiple negative COVID-19 tests before and after the eruption. She was initially examined in urgent care and presumed to have a viral or bacterial infection, and she was treated with empiric doxycycline, azithromycin, and acetaminophen. Physical examination revealed generalized targetoid lesions on the extremities, including the palms and soles, with rare lesions on the trunk. There was no mucosal or nail involvement. The patient received a clinical diagnosis of EM secondary to the COVID-19 vaccine, given the classic targetoid skin lesions and temporal relationship to vaccination. She was started on a prednisone taper, and the antibiotics were discontinued; her rash and symptoms resolved.  No follow up attempts are possible, information about lot/ batch number cannot be obtained, no further information can be expected.  Follow-up (19Jan2023): This is a literature report. This is a follow-up report based on the receipt of the publication; the case has been updated to include additional information identified in the publication. Updated information included: Reporter and Literature information were added.; Sender's Comments: As there is limited information in the case provided, the causal association between the event and the suspect drug BNT162B2 cannot be excluded.  The impact of this report on the benefit-risk profile of the Pfizer product and on the conduct of the study is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.