Neutrophilic dermatosis with necrobiotic changes as an unusual manifestation after the first shot of a <scp>COVID</scp> ?19 <scp>mRNA</scp> vaccine together with a high fever and liver injury

Coronavirus disease 19 (COVID-19) mRNA vaccines sometimes cause various skin rashes. We report an unusual case of erythema nodosum-like nodules with vesicular and pustular papules, which arose after the first shot a COVID-19 vaccine. A biopsy showed marked neutrophilic infiltration necrobiotic changes throughout dermis subcutis. Immunohistochemically, CD8+ cells were much more common than CD4+ in dense infiltrates. Many CD68+ macrophages present around cells. No cases dermatosis have been reported. Thus, our findings should be added to cutaneous adverse effects vaccines.