pityriasis rosea and covid vaccine

McMahon DE, Amerson E, Rosenbach M, Lipoff JB, Moustafa D, Tyagi A, Desai SR, French LE, Lim HW, Thiers BH, Hruza GJ, Blumenthal KG, Fox LP, Freeman EE. Accessibility Pityriasis Rosea-like eruptions following COVID-19 mRNA-1273 vaccination: A case report and literature review. Is there a prescription cream or ointment that you can prescribe? You may develop a raised, discolored, circular or oval-shaped patch that ranges from 1 to 6 centimeters (cm). 2022 Nov 1;43(6):555-558. doi: 10.2500/aap.2022.43.220058. Clin Exp Dermatol 2010;35:3004. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). COVID-19: Cutaneous manifestations and issues related to - UpToDate How do dermatologists treat pityriasis rosea? Few brownish patches also appeared, suggestive of post-inflammatory hyperpigmentation. In: Kelly A, Taylor SC, Lim HW, et al., eds. J Invest Dermatol. Epub 2021 Jun 10. Leerunyakul K, Pakornphadungsit K, Suchonwanit P. Front Med (Lausanne). Diagnoses: If you have a very itchy rash, your healthcare provider may prescribe the following to help relieve your symptoms: There are several over-the-counter products or home remedies that can help stop your rash from itching. (2020) 83:e5760. Lasers Med Sci. Treatment with topical 0.1% triamcinolone acetonide twice per day showed partial response after seven days. Br J Dermatol. This rash is thought to be caused by a virus. Cleveland Clinic is a non-profit academic medical center. Please enable it to take advantage of the complete set of features! 8600 Rockville Pike Additionally, differences in incidence of this reaction after Pfizer and Moderna vaccination may suggest a differing host immune response incited by these vaccines which warrants further investigation. Bin Rubaian NF, Almuhaidib SR, Aljarri SA, Alamri AS. doi: 10.1111/jdv.12942, 13. FOIA official website and that any information you provide is encrypted It is usually seen in children, adolescents, and young adults. and transmitted securely. 18. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: a registry-based study of 414 cases. Studies show that the development of pityriasis rosea during pregnancy may cause birth complications, including miscarriage and poor muscle tone and development once the baby is born (neonatal hypotonia). 2022 Aug 11;9(8):43. doi: 10.3390/medicines9080043. Pityriasis Rosea-like eruptions following COVID-19 mRNA-1273 vaccination: A case report and literature review. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753512/), Visitation, mask requirements and COVID-19 information, sexually transmitted disease or infection. (d) Patient 2: Closeup of plaques, with the hyperpigmented centre and trailing scale. The site is secure. Laboratory investigation results (i.e., complete blood count, blood chemistry, C-reactive protein level, erythrocyte sedimentation rate, serological test for syphilis, plasma polymerase chain reaction (PCR) for human herpesvirus (HHV)-6 and HHV-7, and reverse transcription-PCR for COVID-19) were unremarkable. Med Clin (Barc). Pityriasis Rosea as a Possible Complication of Vaccination Against COVID-19. Atypical pityriasis rosea associated with mRNA COVID-19 vaccine. Cutaneous reactions after COVID-19 vaccination in Turkey: A multicenter study. For most people, it resolves without treatment. J Formos Med Assoc. Borgia F, Li Pomi F, Alessandrello C, Vaccaro M, Pioggia G, Gangemi S. J Dermatol. Epub 2022 Jun 19. 2022 Nov 6;15:2369-2382. doi: 10.2147/CCID.S388245. The papillary dermis shows melanin incontinence, perivascular lymphocytic infiltrate and rare scattered extravasated red blood cells. Oueijan RI, Hill OR, Ahiawodzi PD, Fasinu PS, Thompson DK. A 52-year-old Thai woman with a one-year history of recurrent glioblastoma was admitted to our hospital for a planned targeted therapy. Authors Jordan E Buckley 1 , Laura N Landis 2 , Ronald P Rapini 1 Affiliations An official website of the United States government. Figure 2. Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Clin Cosmet Investig Dermatol. Disclaimer. Epub 2022 Jun 21. Br J Dermatol 2021. No one knows what causes pityriasis rosea, though healthcare experts think a virus might be responsible. Among patients who received COVID-19 vaccines, PR-like eruptions have been reported following the first (n = 1) or second dose (n = 2) of BNT162b2 mRNA-based vaccines (3, 4). Your symptoms dont improve after treatment. Fortunately, PR-like eruption is responsive to topical corticosteroids without any systemic adverse effects. Pityriasis lichenoides has distinct acute and chronic forms, which are usually distinct . Dermatol Reports. Epub 2022 Jan 5. A 3-cm oval plaque with peripheral scale, larger than the other lesions, was present on the inferior portion of the right breast. Before Careers. Pityriasis rosea is a benign inflammatory rash that starts with a single red rash, also known as the "herald patch," which eventually gives way to a larger, similar-looking rash on the trunk. Generalized Papulovesicular Eruption as a Side Effect of the Pfizer-BioNTech COVID-19 Vaccine. Would you like email updates of new search results? Theyre both papulosquoamous (pap-you-lo-skway-miss) disorders, which is a term used to characterize skin disorders according to the presence of raised, discolored, scaly patches of skin. However, if you scratch your patches, you may break your skin, leading to an infection that can cause pain. The etiopathogenesis of PR is still unknown, but is frequently associated with episodes of upper respiratory tract infections. Pityriasis Rosea Shortly After mRNA-1273 COVID-19 Vaccination. doi: 10.1111/jdv.17301. Vote for your favorite beauty products now! -, Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. -, Busto-Leis J.M., Servera-Negre G., Mayor-Ibarguren A., et al. Epub 2022 Feb 9. 2021;85(1):4655. 2022 Nov;36(11):1947-1968. doi: 10.1111/jdv.18294. Epub 2022 Jul 19. Indian J Dermatol 2016;61:37584. Could covid-19 infection cause pityriasis rosea why? I put on some hydrocortisone and went to sleep, then woke up with another mark on my side, a couple inches below my armpit. When to test for COVID-19 using real-time reverse transcriptase polymerase chain reaction: a systematic review. sharing sensitive information, make sure youre on a federal This site needs JavaScript to work properly. Even though it is benign, it can cause substantial. Histopathological findings of pityriasis rosealike eruption in patient 1. Pityriasis rosea is also known as Christmas tree rash. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. Careers. Federal government websites often end in .gov or .mil. (No.) JAAD Case Rep 2018; 4: 800801. Our reported case adds to the other findings regarding the association of PR with SARS-CoV-2 infection, in the context of the pandemic, suggesting the need to test patients with PR skin lesions for SARS-CoV-2 infection. (2021). Dermatol Ther. A few days later, the cluster came: Ten little dots arranged themselves in a perfect alien-like crop circle on my upper back, and they itched so much that I scratched them raw. While home remedies are safe for most people, its a good idea to check with your healthcare provider before trying some of the following options. doi: 10.1111/dth.15601. Coronavirus disease 2019 and pityriasis rosea: A review of the immunological connection. Epub 2021 Aug 7. 2020 Sep 25;155(6):273. doi: 10.1016/j.medcli.2020.05.024. Some research shows that people who follow a Mediterranean diet have lower levels of inflammation in their bodies. Physicians should be aware that pityriasis rosea is a rare side-effect of COVID-19 vaccination.Pityriasis rosea is self-limiting and no medical treatment is usually required. A case of Pityriasis rosea is presented in a 66-year-old black male 1 week after administration of the Pfizer-BioNTech COVID-19 vaccine. Allergy Asthma Proc. Epub 2020 Jun 5. This reaction is self-limited and resolves in an average of 5.6 weeks. User Agreement and Privacy Policy and Cookie Statement and At home, she underwent systemic treatment with antihistamines and topical medication with dermatocorticosteroids. Epub 2022 Jun 21. Pityriasis rosea-like rash after messenger RNA COVID-19 vaccination: A case report and review of the literature. Some studies have identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike proteins on endothelial cells and lymphocytes from PR-like lesions, consistent with direct viral invasion (3, 4). An official website of the United States government. Pityriasis rosea - Diagnosis and treatment - Mayo Clinic Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review. -, Drago F, Ciccarese G, Javor S, Parodi A. Vaccineinduced pityriasis rosea and pityriasis rosealike eruptions: a review of the literature. Although histopathologic characteristics of PR are also observed in PR-like lesions, the presence of dyskeratotic keratinocytes, interface dermatitis, and eosinophilic infiltration in the dermis may be more prominent in PR-like eruptions (11). 2021 Sep;35(9):e546-e548. Pityriasis rosea-like eruption revealing COVID-19. Authors Lina Abdullah 1 eCollection 2022. Due to the rising incidence of coronavirus disease 2019 (COVID-19) worldwide, mass vaccination has been the cornerstone in preventing viral spread and decreasing morbidity and mortality. Bethesda, MD 20894, Web Policies 2005;124(6):12341240. PMC Pityriasis rosea-like rash after messenger RNA COVID-19 vaccination: A From grooming sets to self-care gadgets, we've got them covered. Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Clin Cosmet Investig Dermatol. . doi: 10.1111/dth.13650, 7. I figured a very determined mosquito had snuck into my room and attacked me through my tank top. 2021 May;62(2):e333-e334. . Int J Infect Dis. All rights reserved. Bethesda, MD 20894, Web Policies Pityriasis rosea (PR)-like eruption is a cutaneous complication associated with several medications and vaccinations. Pityriasis Rosea Associated With COVID-19 Vaccination: A Common Rash Following Administration of a Novel Vaccine. Oily fish, such as mackerel, salmon or sardines. doi: 10.7759/cureus.27108. Cured meats with nitrates, such as hot dogs. Ehsani AH, Nasimi M, Bigdelo Z. Pityriasis rosea as a cutaneous manifestation of COVID-19 infection. Bookshelf Copyright 2021 Leerunyakul, Pakornphadungsit and Suchonwanit. Unable to load your collection due to an error, Unable to load your delegates due to an error. Clipboard, Search History, and several other advanced features are temporarily unavailable. They indicate that eight types of rash could be signs of Covid-19, including red toes and fingers, chest eczema and pityriasis rosea (scroll down for the full list). 2021 Aug;185(2):e34. 8600 Rockville Pike Unauthorized use of these marks is strictly prohibited. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article. Your Random Rash Could Be Pityriasis Rosea - Yahoo! However, some people believe that eating an anti-inflammatory diet may relieve itching. 2022 Nov 6;15:2369-2382. doi: 10.2147/CCID.S388245. Bethesda, MD 20894, Web Policies Khalili M, Abtahi-Naeini B, Rastegarnasab F, Afshar K. Clin Case Rep. 2022 Jul 19;10(7):e6096. 8600 Rockville Pike Cutis. See this image and copyright information in PMC. 8:752443. doi: 10.3389/fmed.2021.752443. Bethesda, MD 20894, Web Policies The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of Cond Nast. 2021 Aug;185(2):e34. "It looks very different.". JAAD Case Rep. 2021;7:9394. Accessibility Pityriasis rosea-like eruption presenting as multiple discrete erythematous oval patches and plaques on the back (A) lower abdomen, and bilateral upper thighs (B); lesions distributed along cleavage lines without prominent scales (C). Would you like email updates of new search results? These conditions lasted 8.6 days on average. 2022 Nov;36(11):1947-1968. doi: 10.1111/jdv.18294. A 3-cm oval plaque with peripheral scale, larger, MeSH Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. It was described as "clinically reminiscent" of pityriasis rosea by the authors, from the divisions of dermatology and venereology, pathology, intensive care, and the virology laboratory, of the Hpital Cochin, Paris. Unable to load your collection due to an error, Unable to load your delegates due to an error. Drago F, Ciccarese G, Javor S, et al. doi: 10.1111/jdv.17316, PubMed Abstract | CrossRef Full Text | Google Scholar, 2. Dermatology. eCollection 2022. What at-home treatments do you recommend? There isnt a cure, but it isnt contagious. Once its gone, you likely wont develop it again. Unable to load your collection due to an error, Unable to load your delegates due to an error. Influenza viruses and vaccines have triggered pityriasis rosea in some cases.". doi: 10.1111/ijd.13061. In some cases, central hyperpigmentation was identified. Clipboard, Search History, and several other advanced features are temporarily unavailable. Pityriasis Rosea Associated With COVID-19 Vaccination: A Common Rash Following Administration of a Novel Vaccine. Shabazz DR. Pityriasis Rosea. Use of this site constitutes acceptance of our Pityriasis rosea-like rash after messenger RNA COVID-19 vaccination: A Its important to pay attention to your skin. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Kroumpouzos G, Paroikaki ME, Yumeen S, Bhargava S, Mylonakis E. Microorganisms. Marzano AV, Cassano N, Genovese G, Moltrasio C, Vena GA. Cutaneous manifestations in patients with COVID19: a preliminary review of an emerging issue. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. COVID-19 Skin Manifestation Heterogeneity - MedicineNet Published by Wolters Kluwer Health, Inc. 2021;35(8):e489e491. 2023 Feb 9;11(2):397. doi: 10.3390/vaccines11020397. PMC Due to the rising incidence of coronavirus disease 2019 (COVID-19) worldwide, mass vaccination has been the cornerstone in preventing viral spread and decreasing morbidity and mortality. Various mild and benign cutaneous manifestations of the different forms of the COVID-19 vaccine have been documented. In: Knoop KJ, Stack LB, Storrow AB, et al., eds. A virus may cause pityriasis rosea, but experts aren't sure. The Moderna and Pfizer-BioNTech COVID-19 vaccines are the first two COVID-19 vaccines authorized by the Food and Drug Administration for emergency use and already have been given to millions of Americans. While annoyingly itchy, the rash does not cause any serious long-term side effects and is not contagious, unlike the diseases these vaccines protect against. Disclaimer. Foods that have anti-inflammatory properties include: Foods that may increase inflammation include: There isnt any way to prevent pityriasis rosea. If you have pityriasis rosea, you dont have to avoid any foods or drinks. doi: 10.1111/dth.13730. The .gov means its official. Accessibility The site is secure. These types cannot cause cold sores or genital herpes. Bethesda, MD 20894, Web Policies The average time between vaccination and rash onset is 10 days, and most patients experience pruritus (70%). Pityriasis rosea (PR)-like eruption is a rare cutaneous complication of immunization. Coronavirus pandemic (COVID-19), McMahon D.E., Amerson E., Rosenbach M., et al. official website and that any information you provide is encrypted sharing sensitive information, make sure youre on a federal How quickly did it come on, and did my boyfriend also have it? Although the exact pathogenesis of PR is unknown, current evidence suggests that an inflammatory reaction due to a viral trigger may lead to the cutaneous manifestations. Martora F, Battista T, Marasca C, Genco L, Fabbrocini G, Potestio L. Clin Cosmet Investig Dermatol. Treatment with topical 0.1% triamcinolone acetonide twice daily showed partial response after seven days. Would you like email updates of new search results? 7 Articles, This article is part of the Research Topic, Creative Commons Attribution License (CC BY), Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. -, Broccolo F, Drago F, Careddu AM, et al. New York City-based dermatologist Macrene Alexiades. Pityriasis rosea (PR)-like eruption is a cutaneous complication associated with several medications and vaccinations. The patient presented to the Department of Dermatology for a 3 week duration of an extremely pruritic erythematous-squamous lesion, initially on the trunk and upper limbs, with extension to the lower limbs in the last week and the lesion respected the cephalic extremity, palms, and soles. Please enable it to take advantage of the complete set of features! Bookshelf Women are 50% more likely to develop pityriasis rosea. If I dont have pityriasis rosea, what other skin condition might I have? The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). eCollection 2022. 6 Called a "herald patch,". Involvement of the oral mucosa has also been reported in as many as 50% of all cases (11). official website and that any information you provide is encrypted Disseminated erythematous-papulosquamous lesions, with right laterocervical herald patch (clinical aspect on admission). Pearls and pitfalls: Adverse cutaneous reactions after COVID-19 vaccination. In conclusion, we have described the first case of PR-like eruption following ChAdOx1 nCoV-19 (Oxford/AstraZeneca) vaccination. Pityriasis rosea following CoronaVac COVID-19 vaccination: a case report. The clinical and pathologic spectrum of mucocutaneous reactions Had I started new medication? Clinical aspect of the lesions after 7 days of treatment. Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature. J Eur Acad Dermatol Venereol 2016; 30: 544-545. Before Pityriasis rosea Gibert triggered by SARS-CoV-2 infection: A case Pityriasis rosea is a benign inflammatory rash that starts with a single red rash, also known as the "herald patch," which eventually gives way to a larger, similar-looking rash on the trunk within days or weeks, says dermatologist Corey L. Hartman, founder of Skin Wellness Dermatology in Birmingham, Alabama. Previously, PR has been reported in temporal association with various viral inoculations. doi: 10.1111/bjd.20143. Your skin may develop discolored patches (lesions) that look like scales or dry, crinkly paper. Please enable it to take advantage of the complete set of features! Martn Enguix D, Salazar Nievas MDC, Martn Romero DT. Some people develop a few large patches on their skin. See this image and copyright information in PMC. Clin Dermatol. The rash itself usually doesnt blister or bleed, but in many cases, the skin may peel. Frontiers | Case Report: Pityriasis Rosea-Like Eruption Following COVID Int J Infect Dis. Pityriasis means scaly, and rosea means pink, but the rashes may look red, gray, brown or purple. Drug-induced PR-like eruption accounts for 2% of all cutaneous adverse drug reactions (10). Numerous scattered erythematous plaques with fine scale oriented along skin cleavage, Herald patch of pityriasis rosea. 2022 Jun;7:164-168. doi: 10.1016/j.jdin.2022.01.009. In: Jameson J, Fauci AS, Kasper DL, et al., eds. Clinical manifestations and histopathologic findings of reported patients with pityriasis-rosea like eruptions following COVID-19 vaccination. Pityriasis rosea, COVID-19 and vaccination: new keys to understand an old acquaintance. Characterization of the inflammatory cell infiltrate in herald patches and fully developed eruptions of pityriasis rosea. Disseminated erythematous-papulosquamous lesions, with right. Those ensuing spots like the circle of dots that erupted on my back a day after the initial raised welt appeared typically resemble a Christmas tree-like formation. The appearance of pityriasis rosea following the first injection of the AstraZeneca vector vaccine suggests a causal connection. We present the case of a female patient in whom the diagnosis of pityriasis rosea led to the investigation and diagnosis of the SARS-CoV-2 infection. According to King, an in-person skin exam is usually enough to make an accurate diagnosis, though a biopsy or blood work may be necessary for some. 2022 Jul 21;14(7):e27108. Atzori L, Pinna AL, Ferreli C, Aste N. Pityriasis rosea-like adverse reaction: review of the literature and experience of an Italian drug-surveillance center. 2021 Oct;20(10):3080-3084. doi: 10.1111/jocd.14372. This Month in JAAD International: August 2022: Cutaneous reactions to COVID-19 messenger RNA booster dose vaccination. eCollection 2021. Busto-Leis JM, Servera-Negre G, Mayor-Ibarguren A, Sendagorta-Cuds E, Feito-Rodrguez M, Nuo-Gonzlez A, et al. Pityriasis lichenoides is a clonal T-cell disorder that may develop in response to foreign antigens (eg, infections or drugs) and may be associated with cutaneous T-cell lymphoma. However, several adverse effects of COVID-19 vaccination have been identified. Inverse pityriasis rosea secondary to COVID-19 vaccination. Cutis. sharing sensitive information, make sure youre on a federal I tell my patient to use a gentle non-soap cleanser." PMC doi: 10.12998/wjcc.v5.i6.203, 6. The available COVID-19 vaccines entail different levels of risk for skin reactions. Women and young people are most likely to have these reactions. (Unfortunately, I scratched my rash until it bled, so my hyperpigmentation may linger.). While my particular flare-up itched a lot, that's not always the case. retailers. It looked like one, and it certainly itched like one but then more came. 2022 Jul 8;101(27):e29823. "However, it's possible to develop the rash more than once," she says. Of the reported cases, 96.7% were secondary to the Pfizer vaccine, with only 1 reported . 2022 Aug;20(8):1123-1124. doi: 10.1111/ddg.14784. sharing sensitive information, make sure youre on a federal Parakeratosis with minimal acanthosis, MeSH 2021 Sep 7;8:752443. doi: 10.3389/fmed.2021.752443. F. Drago, G. Ciccarese, A. Parodi Under the treatment that was initiated a partial remission of the lesions after 7 days was observed. Moreover, central dusky-red erythematous was observed on some plaques (Figure 2A). PS conceptualized the case report and revised the manuscript. The https:// ensures that you are connecting to the eCollection 2022 Feb. Kroumpouzos G, Paroikaki ME, Yumeen S, Bhargava S, Mylonakis E. Microorganisms. J Am Acad Dermatol. One case of pityriasis rosea is reported in a patient infected with COVID-19, and the most commonly reported features are exanthomatous rash, urticaria, chickenpox like vesicles, petechiae, and acute hemorrhagic edema of infancy. Drago F, Ciccarese G, Rebora A, et al. 2022 May;11(2):222-225. doi: 10.7774/cevr.2022.11.2.222. The .gov means its official. Epub 2021 Nov 2. We present two cases of COVID-19 vaccine-induced pityriasis rosea. Akdas E, Ilter N, Ogut B, Erdem O. Pityriasis rosea following CoronaVac COVID-19 vaccination: a case report. Suchonwanit P, Rojhirunsakool S, Khunkhet S. A randomized, investigator-blinded, controlled, split-scalp study of the efficacy and safety of a 1550-nm fractional erbium-glass laser, used in combination with topical 5% minoxidil versus 5% minoxidil alone, for the treatment of androgenetic alopecia. A case of Herpes Zoster Ophtalmicus after third dose of Comirnaty A virus may cause pityriasis rosea, but experts arent sure. In a registry-based study, PR-like eruption was observed in only 12% of patients (14). In addition to a corticosteroid cream, New York City-based dermatologist Macrene Alexiades recommends keeping showers short and lukewarm, as "water, sweat, and soap reportedly irritate and inflame the lesions. Pityriasis Rosea Induced by COVID-19 Vaccination Eur J Case Rep Intern Med. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Physical examination revealed that lesions were distributed along cleavage lines, similar to PR, without herald patch or prominent scales (Figure 1C). Rybak-d'Obyrn J, Placek W, Owczarczyk-Saczonek A, Derkaczew M, Joniec E, Hofman R, Stompr M. Clin Cosmet Investig Dermatol. The ones found in people with pityriasis rosea are human herpesviruses 6 and 7. This site needs JavaScript to work properly. (2006) 12:1. doi: 10.5070/D380D8301D, 11. Epub 2022 May 3. PR is a common self-limited papulosquamous eruption typically presenting with a large solitary pink-colored patch or plaque (i.e., herald patch), followed by secondary eruptions of smaller erythematous patches or plaques with associated peripheral collarette scaling distributed along the cleavage lines of the trunk, forming a Christmas tree pattern (5). Medicine (Baltimore). What started as a single, quarter-inch raised welt on my left rib cage eventually morphed into two, then four. How long will it take my body to clear the rash? Parakeratosis with minimal acanthosis and spongiosis of the epidermis. Clinical findings of pityriasis rosealike, Clinical findings of pityriasis rosealike eruption in the patients. 2022 Aug;87(2):295. doi: 10.1016/j.jaad.2022.06.036.

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pityriasis rosea and covid vaccine