Abstract
The pandemic of SARS-CoV-2 during the first years of the 2020s led to a great commitment to develop effective vaccines. Despite the good safety and tolerability profile, vaccines may trigger a broad spectrum of cutaneous side effects. Granulomatous dermatitis has been rarely reported after SARS-CoV-2 mRNA vaccines, but no cases of annular elastolytic giant cell granuloma have been described. Moreover, in our case, it was also associated with a central area of mid-dermal elastolysis, confirming the strong association between these two diseases already reported in the literature. The observation of occasional eosinophils within the infiltrate and the presentation of the cutaneous eruption a few days after the administration of the second dose of the Pfizer/BioNTech (BNT162b2) vaccine are highly suggestive of a drug-related eruption. To our knowledge, this is the first report in the literature of an annular elastolytic giant cell granuloma as an adverse effect of the SARS-CoV-2 vaccination.