National Survey of Psoriasis Flares after 2009 Monovalent H1N1/Seasonal VaccinesSbidian E.a-c · Eftekahri P.d · Viguier M.e, f · Laroche L.k · Chosidow O.a-c · Gosselin P.l · Trouche F.m · Bonnet N.n · Arfi C.o · Tubach F.g-i · Bachelez H.e,f,j · for the Groupe de Recherche sur le Psoriasis from the French Society for Dermatology and the Syndicat National des Dermatologues-Vénéréologues
aService de Dermatologie, Hôpital Henri-Mondor, AP-HP, bUFR de Médecine, Université Paris-Est Créteil, and cINSERM, Centre d'Investigation Clinique 006, Hôpital Henri-Mondor, AP-HP, Créteil; dCentre de Pharmacovigilance, Hôpital Fernand-Widal, AP-HP, eService de Dermatologie, Hôpital Saint-Louis, AP-HP, fSorbonne Paris Cité, Université Paris Diderot, gDépartement d'Epidémiologie et Recherche Clinique, Hôpital Bichat, AP-HP, hUFR de Médecine, Université Paris Diderot, Sorbonne Paris Cité, iCIE 801, INSERM, and jInstitut Imagine, Hôpital Necker-Enfants Malades, AP-HP, Paris; kDepartment of Dermatology, Hôpital Avicenne, AP-HP, Bobigny; lDermatologist, Bayonne; mDermatologist, Rodez; nService de Dermatologie, Hôpital Nord, Marseille; oDermatologist, Issy-les-Moulineaux, France
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Background: Psoriasis is a common chronic immune-mediated disease resulting from interactions of a genetic background with environmental triggering factors such as stress and infection. So far, there is very limited information available about the impact of vaccine stimuli on psoriasis course. Objective: To collect cases of psoriasis flares occurring after vaccination through a national survey. Methods: We investigated cases of onset or flare of psoriasis occurring within 3 months following the 2009 monovalent H1N1/seasonal vaccination during the campaign of the 2009-2010 flu seasons in France. Results: Ten patients, 6 men and 4 women with a median age of 44 years (range 9-88), were reported with a psoriasis of new onset (n = 7) or with a worsening of previously diagnosed psoriasis (n = 3) within a median time period of 8 days following vaccination. Nine of them presented with a mixed guttate/plaque clinical phenotype, and 1 showed 2 successive generalized pustular psoriasis (GPP) flares after 2 different vaccine injections. Conclusion: The short time interval between vaccination and onset of psoriasis flares, the lack of other triggers and the flaring sequence following 2 different vaccines in a GPP patient suggest a possible association between the 2009 monovalent H1N1/seasonal vaccination and psoriasis flaring in the collected cases. Nevertheless, the likely very low incidence of psoriasis following vaccination emphasizes the safe profile and the relevance of vaccination strategies in psoriasis patients, especially in candidates for immunosuppressive treatments.
© 2014 S. Karger AG, Basel
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