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Purpose of reviewPityriasis lichenoides (PL) is a spectrum of dermatological conditions involving polymorphous lesions. Natural history of the condition ranges from acute to chronic. Cases of PL following SARS-CoV-2 infection/vaccination have been reported, but not yet comprehensively reviewed. Hence, the objective of this article is to review and summarize cases of PL following SARS-CoV-2 infection/vaccination in order to guide clinicians in its diagnosis and management.Recent findingsPubMed, Embase, and Web of Science were searched for relevant articles. Thirteen articles, consisting of 14 cases of PL following SARS-CoV-2 infection/vaccination, were identified. Males represented 64.3% of cases, and the average age of those affected was 41.4years. The majority of cases (N = 9, 64.3%) were following SARS-CoV-2 vaccination, the most commonly implicated being Pfizer-BioNTech (n = 8/10, 80%), while four (28.6) followed infection. The overall latency period ranged from 5days to 1month. Treatments varied greatly. However, at the time of follow-up, 12/14 patients (85.7%) had either marked improvement or complete resolution of lesions.SummaryThis review cannot determine causality. However, a temporal association was observed with the case reports, and one case of PL followed SARS-CoV-2 infection and recurred with subsequent vaccination, suggesting an association. Nevertheless, risk of developing PL following SARS-CoV-2 infection/vaccination is likely extremely low. There is also the possibility these cases are purely coincidental. Still, clinicians should be aware of this possible etiology when diagnosing a new or exacerbated case of PL. Finally, given that the majority of patients had marked improvement or complete resolution of lesions at the time of follow-up, clinicians should provide reassurance to their affected patients.

A nine-year old girl admitted to our clinic with two months history of itchy skin eruption, initially started on the arms and then disseminated to all the body including the face. Dermatological examination revealed extensive papulosquamous lesions covered with hemorrhagic crust and central necrosis. Clinically the diagnosis was thought to be pityriasis lichenoides et varioliformis acuta (PLEVA) and a skin biopsy was performed from a lesion which revealed exocytosis and spongiosis in epidermis, edema and exocytosis of erythrocytes in papillary dermis, perivascular lymphocytic infiltration in dermis. In laboratory evaluation, oropharyngeal culture was positive for Streptococcus pyogenes. The analysis of urine sample revealed leucocyturia and Escherichia coli grew on urine culture. Therapy with erythromycin, which was found to be sensitive against both pathogens, and also the main therapeutic agent for PLEVA started 250mg tb 4x1 orally, since the histopathological findings were also compatible with PLEVA. A rapid response was achieved and more than half of the lesions were found to be regressed in ten days. In this report, a child of PLEVA with a rapid and dramatic response to erythromycin therapy is described with a brief literature review.