A case of persistent psoriasis occurring after influenza vaccination

Sir, A thirty-year-old male received influenza vaccination in the upper arm. Several days later, erythema appeared on vaccinated site and spread to trunk extremities. He had no family history of psoriasis. was treated with a topical corticosteroid for three months, which yielded effects and, thus, he referred our hospital. physical examination revealed numerous erythematous, scaly macules scattered extremities thick scales lower (Figs. 1a 1b). The psoriasis area severity index (PASI) score 9.7. We performed skin biopsy from left leg. Histopathology regularly elongated epidermis, an absent granular cell layer parakeratosis corneal layer, subcorneal neutrophil infiltration (Fig. 1c). Immunohistochemistry that CD4- CD8-positive T-cells infiltrated into epidermis dermis, IL-17, CD123, TNF-a were also detected inflammatory cells below epidermis. diagnosed started treatment betamethasone calcipotriol formula (Dovobet) ointment oral cyclosporine (300 mg/day). An improvement lesions other than those observed after two months. However, scaly, erythematous legs resistant therapy. continued thereafter.