Sex: M
Vaccine: COVID19
Symptoms: Investigation, Liver function test, Platelet count, SARS-CoV-2 test, Treponema test
Clinical narrative: Erythrodermic psoriasis eruption associated with SARS-CoV-2 vaccination; This is a literature report.  A 58-year-old male patient received BNT162b2 (BNT162B2), as dose 1, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "guttate psoriasis" (unspecified if ongoing), notes: guttate psoriasis with occasional flares ; "occasional flares" (unspecified if ongoing). The patient's concomitant medications were not reported. Past drug history included: Topical corticosteroids. The following information was reported: ERYTHRODERMIC PSORIASIS (hospitalization), 1 day after the suspect product(s) administration, outcome "recovered", described as "Erythrodermic psoriasis eruption associated with SARS-CoV-2 vaccination". The patient was hospitalized for erythrodermic psoriasis (hospitalization duration: 6 day(s)). The patient underwent the following laboratory tests and procedures: Biopsy: psoriasiform dermatitis; Blood creatinine (0.6-1.25): 1.66 mg/dl, notes: elevated and consistent with an acute kidney injury; Blood culture: Negative; Blood electrolytes: Normal; Granulocyte count (1.99-6.95): 8.35, notes: Unit: 10*3 /ul; Hepatitis A virus test: Negative; Hepatitis B test negative: Negative; Hepatitis C virus test: Negative; HIV test: Negative; exam with a thick and loose yellow-gray scale: confluent bright erythema, notes: thick and loose yellow ray scale on the patient face, torso, and upper extremities; unremarkable; Liver function test: Normal; Platelet count (150-328): 405, notes: Unit: 10*3/ul; SARS-CoV-2 test: Negative; Treponema test: Negative; Vital signs measurement: Normal; White blood cell count (4.20-10.70): 11.48, notes: Unit: 10*3/ul. Therapeutic measures were taken as a result of erythrodermic psoriasis.  Clinical information: His medical history was pertinent for guttate psoriasis with occasional flares but mainly controlled with topical corticosteroids. He denied using any new medications or changes to drugs, changes in diet, or contact with a possible allergen or irritant. Other than the presenting symptoms, the review of systems was negative. He presented to the hospital for 6 days of generalized rash covering his body with partial sparing of the medial thighs and feet. It started a day after he received the Pfizer-BioNTech SARSCoV-2 vaccine. A diagnosis of erythrodermic psoriasis secondary to immunization was made. Following the resolution of his AKI, he was started on cyclosporine 3 mg/kg/day with UVB treatments 3 times a week for 3 months and twice-daily triamcinolone 0.1% cream and hydroxyzine as needed. A week following treatment initiation, drastic improvement was noted with significant sloughing of skin that revealed new, non-irritated skin underneath, and the 3-month follow-up revealed complete resolution.  No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: Based on the information available, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported events of Erythrodermic psoriasis. The impact of this report on the benefit/risk profile of the Pfizer product 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