Title: Emergence of de novo cutaneous vasculitis post coronavirus disease (COVID-19) vaccination

Abstract

A 62 year old Asian female with no past medical history presents with bilateral lower limb non-blanching petechial rash 7 days after the first dose of Astra-Zeneca COVID-19 vaccination. She had associated generalized headache, myalgia and symmetrical large joint arthralgias. Further investigations did not reveal any other systemic features. Skin punch biopsies revealed findings consistent with a leukocytoclastic vasculitis. The patient was commenced on a rapid tapering course of oral prednisone with good resolution and improvement in her symptoms. This is a case report highlighting that the Astra-Zeneca COVID-19 vaccination can result in the development of vasculitis. It is hoped that this presentation can help clinicians be aware that vasculitis can be a possible adverse reaction to the ChAdOx1 nCoV-19 vaccine, both de novo and pre-existing.