# Post-inflammatory Pigmentary Alteration (PIPA)-Like Disorder Following COVID-19 Vaccination

## TL;DR

A new skin condition resembling post-inflammatory pigmentary changes was observed after an mRNA-based COVID-19 vaccine.

## Contribution

This is the first reported case of cutaneous hyperpigmentation linked to melanocyte dysfunction following vaccination.

## Key findings

- A case of cutaneous hyperpigmentation was observed after mRNA-based vaccination.
- The hyperpigmentation was attributed to melanocyte dysfunction and melanin overproduction.
- The condition is similar to post-inflammatory pigmentary alteration (PIPA).

## Abstract

SARS-CoV-2 (COVID-19) infection has been associated with various cutaneous manifestations presenting concomitantly with and following clinical resolution of active infection. Similarly, a variety of cutaneous conditions after mRNA-based COVID-19 vaccination, including specific local injection-site reactions, type I hypersensitivity, type IV (delayed) responses, and autoimmune-mediated reactions, has been observed. The commonality between natural infection and vaccination-related skin findings suggests a molecular mimicry of an immunologic nature. We present a case of a previously undescribed incident of cutaneous hyperpigmentation secondary to melanocyte dysfunction and melanin overproduction, triggered by an inflammatory event, in this case, immunization with an mRNA COVID-19 vaccine.