Sex: M
Vaccine: COVID19
Symptoms: Blood immunoglobulin M, C-reactive protein, Erythema multiforme, Laboratory test, Physical examination
Clinical narrative: Erythema multiforme; This is a literature report.  A 50 year-old male patient received bnt162b2 (BNT162B2) (Batch/Lot number: unknown) as dose 2, single for covid-19 immunisation. Relevant medical history included: "hyperlipidemia" (unspecified if ongoing); "anxiety disorder" (unspecified if ongoing). The patient's concomitant medications were not reported. Vaccination history included: Bnt162b2 (first dose), reaction(s): "covid-19 immunization". The following information was reported: ERYTHEMA MULTIFORME (medically significant), outcome "recovered", described as "Erythema multiforme". The event "erythema multiforme" was evaluated at the emergency room visit. The patient underwent the following laboratory tests and procedures: blood immunoglobulin m: negative; c-reactive protein: elevated; laboratory test: significant for elevated erythrocyte sedimentation, notes: rate and C-reactive protein, negative HSV and varicella zoster virus polymerase chain reaction, and negative mycoplasma immunoglobulin M. Serologic antibody tests were consistent with previous Epstein Barr virus and HSV infections; physical examination: significant for erytheatousatous targetoid plaques, notes: on the trunk and extremities, bullae on Q9 the palmoplantar skin, and  hemorrhagic  crusts on the oral mucosa; red blood cell sedimentation rate: elevated; sars-cov-2 test: negative; viral test: negative; negative. Therapeutic measures were taken as a result of erythema multiforme.  Clinical course: Patient with a past medical history of hyperlipidemia and anxiety disorder presented with a worsening rash associated with pruritus for 4 days. The patient reported that he experienced changes in his voice, difficulty swallowing, shortness of breath, fatigue, a fever that improved with ibuprofen, and an episode of chest pain on the previous evening. He had been exposed to his son, who had tested positive for COVID-19 11 days previously, but multiple COVID-19 tests in the interim were negative. He had received the second dose of the BNT162b2 COVID-19 vaccine 5 days before the onset of symptoms. Physical examination was significant for erythematous targetoid plaques on the trunk and extremities, bullae on the palmoplantar skin, and hemorrhagic crusts on the oral mucosa. Laboratory findings were significant for elevated erythrocyte sedimentation rate and C -reactive protein, negative HSV and varicella zoster virus polymerase chain reaction, and negative mycoplasma immunoglobulin M. Serologic antibody tests were consistent with previous Epstein Barr virus and HSV infections. The patient received a diagnosis of EM secondary to the COVID-19 vaccine, given the recent exposure to the vaccine and no evidence of other etiologies. He was advised to start using a topical corticosteroid in addition to a prednisone taper that had been started 2 days earlier in the emergency department. His symptoms and rash subsequently resolved.  No follow-up attempts are needed; information about lot/batch number cannot be obtained; Sender's Comments: Based on the information available and close temporal association, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported events . The case will be reassessed once new information is available   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.,Linked Report(s) : US-PFIZER INC-202200202607 Same article/ drug/event and different patient