Vitiligo and coronavirus disease 2019 vaccination: a systematic review

Introduction The global pandemic caused by severe acute respiratory syndrome coronavirus 2 has resulted in a wide range of devastating consequences. While vaccines are essential in combating coronavirus disease 2019 (COVID-19), they have been linked to several adverse effects, including vitiligo. A systematic review was conducted to investigate the occurrence of new-onset vitiligo or exacerbation of existing vitiligo following COVID-19 vaccination. This review outlines demographic profiles, vaccine types, co-morbidities, vaccine doses, systemic associations, onset or recovery patterns, and treatment methods. Objective To evaluate the onset or worsening of vitiligo post-COVID-19 vaccination. Patient and methods Studies published between January 2021 and May 2022 that reported cases of vitiligo following COVID-19 vaccination were reviewed. Only studies documenting new-onset vitiligo or worsening of stable vitiligo were included. The analysis focused on vaccine type, timing of vitiligo onset or exacerbation, family history of vitiligo, personal history of autoimmune diseases, treatment administered, and outcomes. Results A total of 534 papers were screened, of which 28 studies reported vitiligo after COVID-19 vaccination. Ultimately, 17 studies involving 17 patients with new-onset or worsening vitiligo were included in the analysis. The BNT162b2 (Pfizer mRNA) vaccine was the most frequently associated vaccine ( n =9, 52.9%). Most incidents occurred after the first dose and within 7 days of vaccination. Two (18%) patients had a family history of vitiligo while seven (41%) had a history of autoimmune diseases. All patients were monitored following the initiation of treatment. Conclusion This review highlights the need for further investigation into the link between COVID-19 vaccination and the development of vitiligo. The occurrence of new-onset or worsening of stable vitiligo after COVID-19 vaccination is not uncommon. All patients received topical therapy or phototherapy and were actively followed-up. The benefits of anti-COVID-19 vaccination outweigh the suspected adverse effects, and therefore, vaccination should be encouraged.