Lower Eyelid Complication After Blepharoplasty and COVID-19 Vaccination.

[BACKGROUND] Following COVID-19 mass vaccination campaign, new- and unknown-related reactions have emerged.

[CASE REPORT] Four months after transcutaneous lower blepharoplasty and few days after the second dose of SARS-CoV-2 Pfizer mRNA vaccination, a 57-year-old man developed a bilateral palpebral ecchymosis. While the lesion healed spontaneously on the left side, the ecchymosis on the right lower lid did not regress. It presented swelling and hard consistency, clinically involving only skin layer. No alterations were revealed upon blood tests and instrumental evaluations. Histological examination showed lymphovascular hyperplasia on a probable reactive basis. The lesion was resistant to medical and surgical therapies. After 15 months, it regressed spontaneously.

[CONCLUSIONS] In the reported case, an evident chronological relationship exists between surgical site and vaccine reaction, while other etiopathogenetic factors were excluded. This case represents a previously undescribed condition linking postvaccination reaction and long-term surgical outcome.

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