In December or 2020, there were a few reports of patients developing transient facial and lip swelling in patients who have received a dose of the Moderna vaccine. All of these patients had previously received hyaluronic acid (HA) fillers. These reactions all resolved quickly and similar reactions have been reported with other COVID-19 vaccines and with other types of vaccinations as well.

In March of 2021, the Canadian Dermatology Association (CDA) issued recommendations regarding COVID-19 vaccinations and hyaluronic acid (HA) dermal filler use.

They recommended:

• The benefits of vaccination far outweigh the possible but extremely rare risks of vaccine-related filler reactions and should not dissuade someone from receiving the vaccine.
• Patients who have received hyaluronic acid dermal fillers in the past may get a COVID-19 vaccination if they so desire.
• If a patient has received a COVID-19 vaccine in the past, they can receive hyaluronic acid dermal fillers in the future.
• It may be preferable to wait two weeks after HA dermal fillers before being vaccinated BUT if the opportunity arises to receive a vaccine earlier, then the patient should consider receiving the vaccine regardless.
• It may be preferable to wait two weeks after a COVID-19 vaccine before receiving a HA dermal filler.

Tapinarof is an investigational drug that is being studied for the treatment of psoriasis and atopic dermatitis. It is a topical aryl hydrocarbon receptor (AhR)-modulating agent. Tapinarof binds and activates AhR, which leads to downregulation of inflammatory cytokines such as interlukin 17.

Phase 2 clinical studies with a topical cream showed improvement in psoriasis after two weeks of cream with maintenance of improvement for 4 weeks after treatment discontinuation.

This prompted a phase 3 clinical trial for psoriasis using tapinarof 1% cream applied once daily. We are now awaiting the results of the randomized controlled trials.

A phase 2b study published in the Journal of the American Academy of Dermatology on the effectiveness of tapinarof on atopic dermatitis showed good improvement following use of topical 1% cream.

Reference:

Efficacy and patient-reported outcomes from a phase 2b, randomized clinical trial of tapinarof cream for the treatment of adolescents and adults with atopic dermatitis. Paller AS, Stein Gold L, Soung J, Tallman AM, Rubenstein DS, Gooderham M.J Am Acad Dermatol. 2021 Mar;84(3):632-638. doi: 10.1016/j.jaad.2020.05.135. Epub 2020 Jun 2.