McMahon DE, Kovarik CL, Damsky W, et al. - The use of clinical and histopathologic correlation allowed for the classification of cutaneous COVID-19 vaccine reactions. Following COVID-19 vaccination, the authors propose defining a subset of vaccine-related eruption of papules and plaques (V-REPP), as well as 12 other patterns.

• The authors assessed all reports of COVID-19 associated vaccination reactions for the history of skin biopsy from an international registry.

• Of the 803 reported vaccine reactions, 58 (7%) had biopsy reports available for review.

• Spongiotic dermatitis was the most common histopathologic reaction pattern, with clinical manifestations ranging from robust papules with overlying crust to pityriasis-rosea-like eruptions to pink papules with fine scale.

• Other clinical patterns were bullous pemphigoid-like, dermal hypersensitivity, herpes zoster, lichen planus-like, pernio, urticarial, neutrophilic dermatosis, leukocytoclastic vasculitis, morbilliform, delayed large local, erythromelalgia, and others.