背景:迄今为止,世界范围内已报道多例COVID-19疫苗不良反应.斑秃(AA)是一些文献报道的罕见不良反应类型,对患者的社会和心理有重大影响。我们的研究旨在回顾AA和COVID-19疫苗文献。
方法:这项系统评价是通过在Embase等国际数据库中搜索COVID-19疫苗后AA的文章进行的,MEDLINE,PubMed,WebofKnowledge,和奥维德从2019年12月至2023年12月30日。我们纳入了为至少一次COVID-19疫苗接种后的AA患者提供数据的研究。性别数据,年龄,原产国/地区,疫苗类型,疫苗接种和症状出现之间的天数,AA的表现,毛镜和组织病理学发现,治疗,结果包括在内。
结果:总计,确定和评估了579项探索研究,25篇文章共纳入51例患者。27名(52.9%)患者在接受COVID-19疫苗后出现新发AA,24例(47.1%)先前存在疾病的患者在接受COVID-19疫苗后发生AA复发或恶化。据报道,在所有病例中,有五种疫苗会导致AA。辉瑞疫苗(45.1%)是最常见的报道,其次是ChAdOx1nCoV-19疫苗(27.5%),ModernamRNA-1273(19.6%),国药(3.9%)和SinoVac(3.9%)。AA最常发生在第1次给药后1个月内,然后,发病率随时间逐渐下降。38例患者使用了局部或全身皮质类固醇。11例患者接受了Janus激酶抑制剂(jakinib)抑制剂治疗,八与托法替尼,还有三个用了未指定的jakinib.然而,11例患者中有3例在治疗后出现恶化。
结论:COVID-19疫苗接种后AA很少见,医生应该意识到这一现象,以提高早期诊断和适当治疗。
BACKGROUND: To date, multiple cases of adverse reactions to COVID-19 vaccines have been reported worldwide. Alopecia areata (AA) is an uncommon type of adverse reaction reported in some articles and has a significant social and psychological impact on patients. Our study aimed to review the AA and COVID-19 vaccine literature.
METHODS: This systematic review was conducted by searching for articles on AA following COVID-19 vaccines in international databases such as Embase, MEDLINE, PubMed, Web of Knowledge, and Ovid from December 2019 to December 30, 2023. We included studies that provided data for AA patients following COVID-19 vaccination with at least one dose. Data on sex, age, country/region of origin, vaccine type, days between vaccination and symptom presentation, manifestations of AA, trichoscopy and histopathological findings, treatment, and outcomes were included.
RESULTS: In total, 579 explored studies were identified and assessed, and 25 articles with a total of 51 patients were included in the review. Twenty-seven (52.9%) patients developed new-onset AA following receiving the COVID-19 vaccine, and AA recurrence or exacerbation occurred after receiving the COVID-19 vaccine in 24 (47.1%) patients with preexisting disease. Five vaccines were reported to cause AA in all cases. The Pfizer vaccine (45.1%) was the most frequently reported, followed by the ChAdOx1 nCoV-19 vaccine (27.5%), Moderna mRNA-1273 (19.6%), Sinopharm (3.9%) and SinoVac (3.9%). AA occurred most frequently within one month after the 1st dose, and then, the incidence decreased gradually with time. Topical or systemic corticosteroids were used in 38 patients. Eleven patients were treated with a Janus Kinase inhibitor (jakinib) inhibitor, eight with tofacitinib, and three with an unspecified jakinib. However, 3 of the 11 patients experienced exacerbations after treatment.
CONCLUSIONS: AA after COVID-19 vaccination is rare, and physicians should be aware of this phenomenon to improve early diagnosis and appropriate treatment.