Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy skin, Urticarial vasculitis
Clinical narrative: Urticarial vasculitis; This literature-study case was reported in a literature article and describes the occurrence of URTICARIAL VASCULITIS (Urticarial vasculitis) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.   LITERATURE REFERENCE: Clinical and histopathological spectrum of delayed adverse cutaneous reactions following COVID-19 vaccination. 2021     Concurrent medical conditions included Acne vulgaris, Allergic rhinitis and Erythema edematous (Patient continued to develop erythematous and edematous plaques on her trunk and extremities for five weeks at which time a skin biopsy was performed.).    On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced URTICARIAL VASCULITIS (Urticarial vasculitis) (seriousness criterion medically significant). The patient was treated with METHYLPREDNISOLONE for Adverse event, at an unspecified dose and frequency and DAPSONE for Adverse event, at an unspecified dose and frequency. At the time of the report, URTICARIAL VASCULITIS (Urticarial vasculitis) was resolving.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, Biopsy skin: sparse interstitial (abnormal) sparse interstitial infiltrate with neutrophils and eosinophils, mild leukocytoclasia and few extravasated erythrocytes. Neutrophils were also seen within vessel walls where there were hints of fibrin deposition and persistence of lesion (Inconclusive) Persistence of lesion 5 week later led to biopsy  which demonstrated evidence of vascular injury..     The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter considered URTICARIAL VASCULITIS (Urticarial vasculitis) to be possibly related.    Concomitant medications were not provided by the reporter.  Additional treatment drugs included antihistamines.  Patient developed urticarial vasculitis, required initiation of dapsone along with antihistamine to suppress her lesion. Patient cutaneous symptoms showed improvement after taking treatment medication. It was reported the clinical and histopathologic features of delayed cutaneous adverse reactions from 12 patients after receiving an mRNA COVID-19 vaccine. It was reported that the patient 9 development of urticaria within 24 hours of vaccination provided a strong temporal association. Reactivation of known urticarial vasculitis had been reported in one patient following an unspecified mRNA vaccine, however there have been no reports to date of de novo urticarial vasculitis following COVID-19 vaccination. Patient declined her second dose due to persistent symptoms.  Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.   This case was linked to MOD-2021-276353, MOD-2021-276439, MOD-2021-276440, MOD-2021-276441, MOD-2021-276442, MOD-2021-276443, MOD-2021-276444, MOD-2021-276446 (Patient Link).; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.