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

Leuk Lymphoma. 2024 Jan;65(1):48-54. doi: 10.1080/10428194.2023.2270766. Epub 2024 Jan 10.

Abstract

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.

Keywords: CD4+ small/medium sized pleomorphic T-cell lymphoproliferative disorder; COVID-19 vaccine; Cutaneous lymphoproliferative disorder; cutaneous lymphoma; cutaneous reactions; lymphomatoid papulosis; vaccination reaction; vaccine mechanism; vaccine-associated lymphoproliferative disorder.

Publication types

  • Review

MeSH terms

  • COVID-19 Vaccines / adverse effects
  • COVID-19* / prevention & control
  • Humans
  • Ki-1 Antigen
  • Lymphomatoid Papulosis* / pathology
  • Lymphoproliferative Disorders* / pathology
  • Male
  • Skin Diseases*
  • Skin Neoplasms* / pathology
  • Vaccination / adverse effects

Substances

  • COVID-19 Vaccines
  • Ki-1 Antigen