Sudden onset of vitiligo after COVID‐19 vaccine

A 33‐year‐old healthy female presented with a 45‐days history of milky‐white well‐demarcated, oval and liner‐shaped macules on her trunk, neck and back which had appeared 1 week after receiving her first dose of Pfizer‐BioNTech COVID‐19 vaccine. The second dose of vaccine was injected 1 months later without the appearance of new macules. She had family history of vitiligo (father) but never suffered from it before. Similar case was observed for a 13-year old girl with family history (father and paternal uncle).  



Similar cases were reported 1 week after the first dose of Pfizer–BioNTech COVID‐19 vaccine in a 58‐year‐old man without family history for vitiligo suffering from ulcerative colitis 3. 
A 69-year-old woman without personal/familiar history of vitiligo and other autoimmune diseases developed vitiligo several days after her first dose of Moderna (mRNA‐1273) COVID‐19 vaccine.  The macules progressed in size, number and degree of hypopigmentation after the booster dose.
A 47-year old male with a history of ankylosing spondylitis for nearly 40 years experienced new onset vitiligo 1 week after the first dose of Pfizer‐BioNTech vaccine BNT162b2 (Comirnaty®). Many more cases have been reported including a 69-year-old male and a 35-year old woman.

Edit: There were more than a dozen cases reported in peer-reviewed literature by the end of 2023. 

REFERENCES

Ciccarese G, Drago F, Boldrin S, Pattaro M, Parodi A. Sudden onset of vitiligo after COVID-19 vaccine. Dermatol Ther. 2022 Jan;35(1):e15196. doi: 10.1111/dth.15196. Epub 2021 Nov 15. PMID: 34751491 PMCID: PMC8646249 doi: 10.1111/dth.15196

Aktas H, Ertuğrul G. Vitiligo in a COVID‐19‐vaccinated patient with ulcerative colitis: coincidence? Clin Exp Dermatol. 2021. doi: 10.1111/ced.14842 [PMC free article] [PubMed] [CrossRef] []

Kaminetsky J, Rudikoff D. New‐onset vitiligo following mRNA‐1273 (Moderna) COVID‐19 vaccination. Clin Case Rep. 2021;9:e04865. doi: 10.1002/ccr3.4865 [PMC free article] [PubMed] [CrossRef] []

Bukhari AE. New‐onset of vitiligo in a child following COVID‐19 vaccination. JAAD Case Rep. 2022;22:68–9. [PMC free article] [PubMed] []

Nicolaidou E, Vavouli C, Koumprentziotis IA, Gerochristou M, Stratigos A. New-onset vitiligo after COVID-19 mRNA vaccination: A causal association? J Eur Acad Dermatol Venereol. 2022 Aug 16:10.1111/jdv.18513. doi: 10.1111/jdv.18513. Epub ahead of print. PMID: 35971993; PMCID: PMC9538607.

Macca L, Peterle L, Ceccarelli M, Ingrasciotta Y, Nunnari G, Guarneri C. Vitiligo-like Lesions and COVID-19: Case Report and Review of Vaccination- and Infection-Associated Vitiligo. Vaccines (Basel). 2022 Sep 30;10(10):1647. doi: 10.3390/vaccines10101647. PMID: 36298511; PMCID: PMC9607983.

Militello M, Ambur AB, Steffes W. Vitiligo Possibly Triggered by COVID-19 Vaccination. Cureus. 2022 Jan 3;14(1):e20902. doi: 10.7759/cureus.20902. PMID: 35145806; PMCID: PMC8809499.

Flores-Terry MÁ, García-Arpa M, Santiago-Sánchez Mateo JL, Romero Aguilera G. Lesiones faciales de vitíligo tras la administración de la vacuna frente a SARS-CoV-2 [Facial Vitiligo After SARS-CoV-2 Vaccination]. Actas Dermosifiliogr. 2022 Jul-Aug;113(7):721. Spanish. doi: 10.1016/j.ad.2022.01.030. Epub 2022 Feb 19. PMID: 35221340; PMCID: PMC8857756.

Gamonal SBL, Gamonal ACC, Marques NCV, Adário CL. Lichen planus and vitiligo occurring after ChAdOx1 nCoV-19 vaccination against SARS-CoV-2. Dermatol Ther. 2022 May;35(5):e15422. doi: 10.1111/dth.15422. Epub 2022 Mar 14. PMID: 35254713; PMCID: PMC9111793.

Koç Yıldırım S. A new-onset vitiligo following the inactivated COVID-19 vaccine. J Cosmet Dermatol. 2022 Feb;21(2):429-430. doi: 10.1111/jocd.14677. Epub 2021 Dec 15. PMID: 34910371.

Caroppo F, Deotto ML, Tartaglia J, Belloni Fortina A. Vitiligo worsened following the second dose of mRNA SARS-CoV-2 vaccine. Dermatol Ther. 2022 Jun;35(6):e15434. doi: 10.1111/dth.15434. Epub 2022 Mar 16. PMID: 35266259; PMCID: PMC9111845.

Tsai TF, Ng CY. COVID-19 vaccine-associated vitiligo: A cross-sectional study in a tertiary referral center and systematic review. J Dermatol. 2023 Aug;50(8):982-989. doi: 10.1111/1346-8138.16799. Epub 2023 Apr 26. PMID: 37186102.

Shi X, Sun Y, Ding X. Impact of COVID-19 Vaccine and COVID-19 Infection on Vitiligo Activity and Progression. Clin Cosmet Investig Dermatol. 2023 Dec 15;16:3581-3587. doi: 10.2147/CCID.S439045. PMID: 38116145; PMCID: PMC10729677.

Tiwari D, Goyal M, Alam A, Verma A. An enigma of sudden-onset vitiligo after COVID-19 vaccination: a literature review. Indian Dermatology Online Journal. 2023 Sep 1;14(5):708-10.

Kasmikha LC, Mansour M, Goodenow S, Kessler S, Appel J. Vitiligo Following COVID-19 Vaccination and Primary Infection: A Case Report and Systematic Review. Cureus. 2023 Sep 19;15(9):e45546. doi: 10.7759/cureus.45546. PMID: 37868489; PMCID: PMC10586347.

Kuznetsov D, Kalyuzhin O, Mironov A, Neschisliaev V, Kuznetsova A. A case of vitiligo after COVID-19 vaccination: a possible role of thymic dysfunction. J Zhejiang Univ Sci B. 2023 Dec 15;24(12):1141-1150. doi: 10.1631/jzus.B2300025. PMID: 38057270; PMCID: PMC10710914.

Tsai TF, Ng CY. COVID-19 vaccine-associated vitiligo: A cross-sectional study in a tertiary referral center and systematic review. J Dermatol. 2023 Aug;50(8):982-989. doi: 10.1111/1346-8138.16799. Epub 2023 Apr 26. PMID: 37186102.


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