Diffuse Alopecia Areata and Its Trichoscopic Findings Following COVID-19 mRNA-1273 Vaccination: A Case Report

Background: Alopecia Areata (AA) is a common autoimmune disease leading to non-scarring hair loss. Previously, AA had been noted following various vaccinations including influenza virus, hepatitis B virus, herpes zoster virus, human papillomavirus, Japanese encephalitis, and Clostridium tetani. During this pandemic, AA following SARS-CoV-2 vaccine injection was rarely reported Objective: We report a case of diffuse AA and its trichoscopic findings following COVID-19 mRNA-1273 vaccination. Method: A trichoscopic examination of the scalp was performed. An English literature review through PubMed and an online search of the Vaccine Adverse Event Reporting System (VAERS) database were conducted. Finding: Only 20 patients of AA following SARS-CoV-2 vaccination were reported in the English literature. Black dots and broken hair were the most common features, followed by yellow dots and exclamation mark hairs. The VAERS database showed 77.8% were associated with the BNT162b2 vaccine and 20.9% with the COVID-19 mRNA-1273 vaccine, respectively. Conclusion: A rare case of AA and its trichoscopic findings following COVID-19 mRNA-1273 vaccine injection was reported. The COVID-19 vaccines may play a role in various immune-related dermatologic conditions.