Age: 78.0
Sex: M
Vaccine: MMR
Symptoms: Extravasation blood, Eye pain, Histology abnormal, Lymphocytic infiltration, Macrophages increased
Clinical narrative: A Case of Leukocytoclastic Vasculitis and Associated Conjunctivitis Following MMR Vaccine Administration; A Case of Leukocytoclastic Vasculitis and Associated Conjunctivitis Following MMR Vaccine Administration; painful rash on his hands, as well as red; painful rash on his hands, as well as red; painful eyes; scattered pink dermal papules with a dusky red center bilateral dorsal and palmar hands; bilateral conjunctival erythema; This case was reported in a literature article and described the occurrence of leukocytoclastic vasculitis in a 78-year-old male patient who received MMR (MMR vaccine) for prophylaxis.   Co-suspect products included lenalidomide for multiple myeloma.   Additional patient notes included He denied any  recent upper respiratory infection or having started any new medications..   On an unknown date, the patient received MMR vaccine and lenalidomide at an unknown dose and frequency. On an unknown date, 2 weeks after receiving MMR vaccine, the patient experienced leukocytoclastic vasculitis (serious criteria GSK medically significant), conjunctivitis (serious criteria GSK medically significant), painful rash, red rash, eye pain, papule and conjunctival redness. The patient was treated with clobetasol. The action taken with lenalidomide was unknown. On an unknown date, the outcome of the leukocytoclastic vasculitis, conjunctivitis, painful rash, red rash, eye pain, papule and conjunctival redness were recovered/resolved.   The reporter considered the leukocytoclastic vasculitis, conjunctivitis, painful rash, red rash, eye pain, papule and conjunctival redness to be related to MMR vaccine.     Additional Information: GSK Receipt Date: 20-Feb-2023 Author Comment:  The author presented a case of a 78-year-old man with a one-year history of lenalidomide therapy for multiple myeloma presented to an outpatient dermatology clinic with a two-day history of a painful rash on his hands, as well as red, painful eyes. He denied any recent upper respiratory infection or having started any new medications. At the clinic visit, physical examination was notable for scattered pink dermal papules with a dusky red center bilateral dorsal and palmar hands, as well as bilateral conjunctival erythema. Differential diagnoses included erythema multiforme, acute febrile neutrophilic dermatosis, erythema elevatum diutinum, and multicentric reticulohistiocytosis. A punch biopsy was taken from the left index finger. Histological examination revealed a dense perivascular and interstitial inflammatory infiltrate composed of lymphocytes, histiocytes, and numerous neutrophils with surrounding papillary dermal edema. High-power views demonstrated scattered nuclear dust and fibrin within the walls of the small blood vessels with extravasation of red blood cells in the surrounding stroma. The patient's histopathological findings were most consistent with leukocytoclastic vasculitis (LCV). Upon discussion with the patient s oncologist, it became known that the patient had received an MMR vaccine two weeks prior to the rash. The patient did not have a history of COVID-19 vaccination. The patient followed up one week later with a more typical appearing rash for LCV. The rash was resolved with the use of topical clobetasol ointment and his eyes were also cleared. The patient has continued to receive lenalidomide without any recurrence of the rash.  " This was an interesting presentation of MMR vaccine-related LCV occurring only on the upper extremities with associated conjunctivitis.In this case, it was unlikely that lenalidomide triggered the patient's vasculitis given that the patient has continued to receive lenalidomide without recurrence of the rash." Additional Supportive Information: This article is not available for regulatory reporting due to copyright restriction