From the JDD Vault: Case Report on Post-COVID-19 Vaccine Photodistributed Hyperpigmentation
Cutaneous reactions and rare dermatologic manifestations linked to COVID-19 vaccination remain a trending topic of discussion among clinicians. In this featured case report from the JDD Vault, authors detail the presentation of a 70-year-old female who developed diffuse blue-grey hyperpigmentation in a photodistributed pattern following her third COVID-19 booster vaccine. Drug-induced hyperpigmentation is most frequently associated with classic pharmaceuticals such as tetracyclines, antimalarials, prostaglandins, and nicotine, none of which were present in this patient’s medical history. Diagnostic workup included a left cheek punch biopsy showing melanin pigment deposition confirmed by Fontana-Masson stain positivity and Prussian blue negativity, with an otherwise unremarkable systemic evaluation.
Rare drug-induced pigmentary changes and post-vaccination skin reactions represent critical clinical considerations for differential diagnosis in modern dermatology practice. While the authors state that a definitive causal relationship cannot be established, the correlation identified through an in-office literature review, combined with the clear onset timeline and absence of classic triggers, positions the booster as a plausible offending agent. Understanding these potential, cosmetically disfiguring cutaneous complications is essential for practicing dermatologists evaluating unexpected pigmentary shifts.
Read the full article in the Journal of Drugs in Dermatology to review the complete case report, biopsy pathology findings, and diagnostic analysis.
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