{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T17:26:37Z","timestamp":1767979597635,"version":"3.49.0"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T00:00:00Z","timestamp":1638489600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Generalized pustular psoriasis (GPP) is characterized by acute flare\u2010ups induced by various factors, but few reports have described GPP onset or flare\u2010up induced by vaccination. To our knowledge, only three such cases following coronavirus disease 2019 (COVID\u201019) vaccination have been reported. We herein report a case of GPP flare\u2010up after COVID\u201019 mRNA vaccination. A 65\u2010year\u2010old man with GPP controlled by infliximab presented with widespread pustular erythema, fever, and malaise following his second COVID\u201019 mRNA vaccination. A skin eruption was apparent at the injection site. He also exhibited systemic capillary leak syndrome (SCLS), which responded rapidly to secukinumab and systemic corticosteroids. Two biopsies, one of which was of the injection site, revealed not only findings typical of GPP, but also a dermal mixed\u2010cell infiltration with eosinophils, and microthrombi in the small dermal vessels. The latter findings have been observed in cutaneous lesions induced by both COVID\u201019 infection and vaccination. This is the first case of a GPP flare\u2010up accompanied by SCLS induced by a COVID\u201019 mRNA vaccine. Also, this is the first flare\u2010up induced by the second vaccine dose, and the first such report including detailed histological data, including for the injection site.<\/jats:p>","DOI":"10.1111\/1346-8138.16271","type":"journal-article","created":{"date-parts":[[2021,12,4]],"date-time":"2021-12-04T04:40:21Z","timestamp":1638592821000},"page":"454-458","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Flare\u2010up of generalized pustular psoriasis combined with systemic capillary leak syndrome after coronavirus disease 2019 mRNA vaccination"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7747-0551","authenticated-orcid":false,"given":"Kazuki","family":"Yatsuzuka","sequence":"first","affiliation":[{"name":"Department of Dermatology Ehime University Graduate School of Medicine  Toon 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