Cutaneous lymphoproliferative disorders after COVID-19 vaccination: clinical presentation, histopathology, and outcomes

• Published in: Leukemia & lymphoma 2024, Vol.65 (1), p.48-54
• Main Authors: Gordon, Emily R, Kwinta, Bradley D, Schreidah, Celine M, Fahmy, Lauren M, Adeuyan, Oluwaseyi, Queen, Dawn, Trager, Megan H, Magro, Cynthia M, Geskin, Larisa J
• Format: Article
• Language: English
• Subjects: COVID-19 - prevention & control; COVID-19 Vaccines - adverse effects; Humans; Ki-1 Antigen; Lymphomatoid Papulosis - pathology; Lymphoproliferative Disorders - pathology; Male; Skin Diseases; Skin Neoplasms - pathology; Vaccination - adverse effects
• ISSN: 1042-8194; 1029-2403
• DOI: 10.1080/10428194.2023.2270766

Individual reports described lymphoproliferative disorders (LPDs) after COVID-19 vaccination; however, the relationship between cases is unexamined. We aim to determine if there are cases of cutaneous LPDs associated with COVID-19 vaccination and their outcomes. We present a review of world literature, vaccine registries, and two unreported cases of LPDs after COVID-19 vaccination. Review of the medical literature, VAERS, and our two cases reveal predominance of Pfizer-BioNTech vaccine, younger patients, and males. All cases resulted in favorable outcomes. Approximately 84% of cases demonstrated CD30+ positivity in their skin biopsies, suggesting that an antigenic trigger may lead to a type IV adaptive immune response, with clonal expansion of CD30+ T-cells and subsequent oncogenic mutational hits eventuating in transient LPDs. LPDs after COVID-19 vaccination appear in the context of the same vaccines (proportionally to their global market shares), share clinical and pathological findings, and have indolent, self-limited character.