Dermatological manifestations associated with COVID-19 and COVID-19 vaccination: results from the Lebanese COVID registry

Background: A number of cutaneous manifestations and adverse cutaneous reactions have been associated with COVID-19 infection and vaccine.

Objectives: A Lebanese national registry was established to characterize the dermatologic manifestations and adverse cutaneous reactions associated with COVID-19 infection and vaccination in a sample of the Lebanese population.

Methods: An observational cross-sectional study was conducted via a web-based clinical form distributed to physicians wishing to report their cases from May 2021 till May 2022.

Results: In total, 142 patients were entered in the registry, of which 133 were adults and nine were pediatric patients. The main dermatological manifestations reported with COVID-19 infection in the adult group were urticaria (32.9%), telogen effluvium (21.4%), morbilliform (10%), and papulosquamous (8.6%) eruptions. Urticaria was the most common adverse cutaneous reaction to the vaccine (33%). Interestingly, herpes zoster was triggered in 12 patients post vaccination in our series with this finding more frequently seen in patients above the age of 41 (P = 0.013). In the pediatric group, the most reported dermatological findings associated with COVID-19 infection were malar erythema (25%) and telogen effluvium (25%). One 16-year-old patient developed lichen planus after one dose of a COVID-19 vaccine. No deaths were reported in both age groups.

Conclusion: This Lebanese registry adds more robust evidence that clinical manifestations of the COVID-19 virus and vaccine are diverse. More studies are necessary to establish the pathophysiology of these dermatological findings in the context of COVID-19 infection and vaccination.