Dermatomyositis Post COVID-19 Vaccine: A Case Report

Abstract

Dermatomyositis (DM) is a rare systemic autoimmune disease characterized by symmetrical and predominantly proximal muscle weakness in the limbs, associated with typical skin lesions. Autoimmune diseases have already been described as an adverse effect of vaccines. Case-report: A 65-year-old Caucasian female patient evolved, 5 days after the first dose of the AZD1222 vaccine against the COVID-19 virus, with skin lesions suggesting heliotrope and Gottron’s sign, with partial improvement of the condition with use of topical glucocorticoids in the lesions. After two months, the patient received the second dose of AZD1222 vaccine, and evolved with proximal muscle weakness of upper and lower limbs, dysphagia, increase of muscle enzymes, in addition to skin lesions compatible with heliotrope and Gottron’s sign again. After treatment with pulse therapy with methylprednisolone 1000 mg per day for three days and treatment with immunosuppressants, she evolved with significant clinical improvement. Conclusions: This case-report demonstrating an important chronological relationship between dermatomyositis and the vaccine AZD1222 alerts to the possibility of the disease as an important adverse reaction of vaccine against COVID-19 virus, as has been recently described by other authors.