title: National survey of psoriasis flares after 2009 monovalent H1N1/seasonal vaccines.
abstract: BACKGROUND
  Psoriasis is a common chronic immune-mediated disease resulting from interactions of a genetic background with environmental triggering factors such as stress and infection. So far, there is very limited information available about the impact of vaccine stimuli on psoriasis course.
  
  
  OBJECTIVE
  To collect cases of psoriasis flares occurring after vaccination through a national survey.
  
  
  METHODS
  We investigated cases of onset or flare of psoriasis occurring within 3 months following the 2009 monovalent H1N1/seasonal vaccination during the campaign of the 2009-2010 flu seasons in France.
  
  
  RESULTS
  Ten patients, 6 men and 4 women with a median age of 44 years (range 9-88), were reported with a psoriasis of new onset (n = 7) or with a worsening of previously diagnosed psoriasis (n = 3) within a median time period of 8 days following vaccination. Nine of them presented with a mixed guttate/plaque clinical phenotype, and 1 showed 2 successive generalized pustular psoriasis (GPP) flares after 2 different vaccine injections.
  
  
  CONCLUSIONS
  The short time interval between vaccination and onset of psoriasis flares, the lack of other triggers and the flaring sequence following 2 different vaccines in a GPP patient suggest a possible association between the 2009 monovalent H1N1/seasonal vaccination and psoriasis flaring in the collected cases. Nevertheless, the likely very low incidence of psoriasis following vaccination emphasizes the safe profile and the relevance of vaccination strategies in psoriasis patients, especially in candidates for immunosuppressive treatments.
authors.affiliation: Service de Dermatologie, Hôpital Henri-Mondor, AP-HP, Créteil, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Sbidian
authors.forename: Pirayeh
authors.initials: P
authors.lastname: Eftekahri
authors.forename: Manuelle
authors.initials: M
authors.lastname: Viguier
authors.forename: Liliane
authors.initials: L
authors.lastname: Laroche
authors.forename: Olivier
authors.initials: O
authors.lastname: Chosidow
authors.forename: Pierre
authors.initials: P
authors.lastname: Gosselin
authors.forename: Fabienne
authors.initials: F
authors.lastname: Trouche
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bonnet
authors.forename: Catherine
authors.initials: C
authors.lastname: Arfi
authors.forename: Florence
authors.initials: F
authors.lastname: Tubach
authors.forename: Hervé
authors.initials: H
authors.lastname: Bachelez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011565:Psoriasis / Q000139:chemically induced / Q000453:epidemiology*; D012189:Retrospective Studies; D012621:Seasons; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines