Two cases of challenging cutaneous lymphoid infiltrates presenting in the context of COVID‐19 vaccination: A reactive lymphomatoid papulosis‐like eruption and a bona fide lymphoma

COVID‐19 infection and vaccination may be associated with a wide variety of cutaneous and immune manifestations. Here, we describe two patients who presented with monoclonal cutaneous T‐cell infiltrates that showed cytologic and immunophenotypic features concerning for lymphoma shortly following COVID‐19 vaccination. In one case, the eruption completely resolved. The second patient showed initial resolution, but her disease recurred and progressed following a breakthrough SARS‐CoV‐2 infection. These cases suggest that immune stimulation following exposure to SARS‐Cov‐2 protein(s) in vaccine or infection may facilitate the development of a lymphoma or lymphoproliferative disorder in susceptible individuals. Moreover, they show that separating these cases from pseudolymphomatous reactive conditions is often challenging and requires close clinical correlation.