Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Vaccination site rash
Clinical narrative: Actinic keratosis; Getting very depressed; A lichenoid drug eruption; Hypersensitivity reaction; Lichenoid photodermatitis; Strange looking rash on the rest of my arm; Rash from the injection site; A bright red itchy rash from the injection site, down the arm, she also spots down towards the elbow area; Arm pain; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ACTINIC KERATOSIS (Actinic keratosis), DRUG ERUPTION (A lichenoid drug eruption), HYPERSENSITIVITY (Hypersensitivity reaction), LICHENOID KERATOSIS (Lichenoid photodermatitis) and PAIN IN EXTREMITY (Arm pain) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 029K201A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Drug allergy and Nickel sensitivity. Concomitant products included VITAMINS NOS and ACETYLSALICYLIC ACID (ASPIRIN 81) for an unknown indication.   On 16-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Feb-2021, the patient experienced PAIN IN EXTREMITY (Arm pain). On 23-Feb-2021, the patient experienced RASH PRURITIC (A bright red itchy rash from the injection site, down the arm, she also spots down towards the elbow area), RASH (Strange looking rash on the rest of my arm) and VACCINATION SITE RASH (Rash from the injection site). On 01-Jun-2021, the patient experienced DRUG ERUPTION (A lichenoid drug eruption), HYPERSENSITIVITY (Hypersensitivity reaction) and LICHENOID KERATOSIS (Lichenoid photodermatitis). On an unknown date, the patient experienced ACTINIC KERATOSIS (Actinic keratosis) and DEPRESSION (Getting very depressed). The patient was treated with FLUOROURACIL (topical) for Rash, at a dose of 5%, 1 dosage form; TRIAMCINOLONE ACETONIDE (topical) for Itching, at a dose of 1 dosage form and CALAMINE, GLYCEROL, ZINC OXIDE (CALAMINE LOTION) (topical) for Itching, at a dose of 1 dosage form. At the time of the report, ACTINIC KERATOSIS (Actinic keratosis), DRUG ERUPTION (A lichenoid drug eruption), HYPERSENSITIVITY (Hypersensitivity reaction), LICHENOID KERATOSIS (Lichenoid photodermatitis), PAIN IN EXTREMITY (Arm pain) and DEPRESSION (Getting very depressed) outcome was unknown and RASH PRURITIC (A bright red itchy rash from the injection site, down the arm, she also spots down towards the elbow area), RASH (Strange looking rash on the rest of my arm) and VACCINATION SITE RASH (Rash from the injection site) had not resolved.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Jun-2021, Biopsy: abnormal (abnormal) Biopsy by Punch Method- Sections shows a band-like infiltrate of lymphocytes and eosinophils which focally obscures the dermal-epidermal junction with vacuolar change. On 01-Jun-2021, Periodic acid Schiff stain: negative (Negative) PAS stain does not highlight fungal organisms or spores. Control stains appropriately.     mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged.       No treatment was provided.   Most recent FOLLOW-UP information incorporated above includes: On 01-Jun-2021: Added patient demographics, medical history (allergy), laboratory tests, 2nd dose of vaccine information, concomitant medications, treatment medications and new events (Actinic keratosis, A lichenoid drug eruption, Hypersensitivity reaction, Lichenoid photodermatitis, Strange looking rash on the rest of my arm, Getting very depressed).  The outcome of the events changed (from resolving to not resolved).