This is a 71 year old retired man who was vaccinated against Covid-19 virus for the fourth time on the 27th March 2024. One day after vaccination, he developed papular lesions of the skin over the buttock regions, the trochanter regions and the elbows on both sides. The surface of the lesions was smooth. There was no pitting oedema or pain. There was mild pruritus and redness of the overlying skin. There was no skin eruption with his three previous covid vaccines. This was his first. Topical steroid ointment was prescribed. After one application the swelling subsided within the next 24 hrs. On the third day a single papular lesion appeared on the skin overlying the head of the left fibula with similar appearance as those on the gluteal region.

A spectrum of skin conditions due to the covid vaccine were described in the past. However little or no information is available on the fourth time vaccinated person and a papular skin eruption seen here. Steroid topical ointment improved the macular eruption suggesting that it was a localised inflammatory reaction of a benign nature.