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Doh JY, Lee JH. A Generalized Lichen Planus Following COVID-19 Vaccination: A Case Report. Ann Dermatol 2023; 35:S260-S264. [PMID: 38061717 PMCID: PMC10727909 DOI: 10.5021/ad.22.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/14/2022] [Accepted: 04/24/2022] [Indexed: 12/20/2023] Open
Abstract
As part of the efforts to overcome the ongoing coronavirus disease 2019 (COVID-19) pandemic, mass vaccination programs against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been initiated. Since then, an increasing number of cutaneous adverse events associated with the COVID-19 vaccines have been reported. Lichen planus (LP) is a rare inflammatory mucocutaneous disease with various clinical presentations, although uncommon, occurring following vaccination. There have been several cases of LP reported following COVID-19 vaccination. However, there has been no report of generalized LP following the COVID-19 vaccine to our knowledge. Herein, we report a case of generalized LP following the Oxford/AstraZeneca (AZD1222) vaccine. A 68-year-old female presented with widespread, erythematous pruritic papules and plaques on the trunk and both limbs, which developed 2 to 3 days after administration of the AZD1222 vaccine. Histopathological examinations revealed cellular interface dermatitis. The patient was diagnosed with generalized LP and was successfully treated with systemic corticosteroid and cyclosporine. As the vaccination campaign against COVID-19 is ongoing and early recognition and treatment are essential to reduce the morbidity of this condition, clinicians should be aware that LP could follow COVID-19 vaccination regardless of the type of vaccine administered.
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Affiliation(s)
- Jee Yun Doh
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Hyun Lee
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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2
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Bin Rubaian NF, Aljalfan AA, Almuhaidib SR. Management of coronavirus disease 2019 vaccine-induced cutaneous complications: A comprehensive literature review. J Family Community Med 2023; 30:161-170. [PMID: 37675215 PMCID: PMC10479027 DOI: 10.4103/jfcm.jfcm_3_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/12/2023] [Accepted: 05/29/2023] [Indexed: 09/08/2023] Open
Abstract
Despite the numerous reports of cutaneous manifestations associated with vaccines for coronavirus disease 2019 (COVID-19), the relationship between COVID-19 vaccines and cutaneous side effects remains unevaluated. In this review, we examine these manifestations and their management. Reported dermatoses included injection-site reaction (early and delayed), type I allergic reaction, morbilliform eruption, pityriasis rosea, Sweet syndrome, lichen planus, psoriasis, herpes zoster reactivation, erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis (TEN). The most common COVID-19 vaccination-related cutaneous manifestations are delayed local reactions, approximately 66% of which are associated with the Moderna vaccine, and 33% with the Pfizer vaccine. Aside from mild injection-site reactions, severe reactions include anaphylaxis and TEN. Most reactions, except for Stevens-Johnson syndrome and anaphylaxis, though unpredictable and unpreventable are mild and can be treated symptomatically. Findings from this review should allow primary care physicians and dermatologists to reach faster diagnosis and initiate prompt intervention.
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Affiliation(s)
- Nouf F. Bin Rubaian
- Department of Dermatology, King Fahad University Hospital, Al-Khobar, Saudi Arabia
| | - Abdullah A. Aljalfan
- Department of Dermatology, King Fahad University Hospital, Al-Khobar, Saudi Arabia
| | - Serene R. Almuhaidib
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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3
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Zou H, Daveluy S. Lichen planus after COVID-19 infection and vaccination. Arch Dermatol Res 2023; 315:139-146. [PMID: 36471086 PMCID: PMC9734460 DOI: 10.1007/s00403-022-02497-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/19/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
Lichen planus (LP) is an inflammatory disorder believed to result from CD8 + cytotoxic T-cell (CTL)-mediated autoimmune reactions against basal keratinocytes. We present a review of LP following COVID-19 infection and vaccination. Literature searches were conducted on PubMed and Google Scholar from 2019 to 7/2022. 36 articles were selected based on subject relevance, and references within articles were also screened. 39 cases of post-vaccination LP and 6 cases of post-infection LP were found among case reports and case series. 152 cases of post-vaccination LP and 12 cases of post-infection LP were found in retrospective and prospective studies. LP is a rare complication of COVID-19 infection and vaccination that may be mediated by overstimulation of T-cell responses and proinflammatory cytokine production. However, it does not represent a limitation against COVID-19 vaccination, and the benefits of vaccination considerably outweigh the risks.
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Affiliation(s)
- Henry Zou
- Michigan State University College of Human Medicine, 15 Michigan St NE, Grand Rapids, MI, 49503, USA.
| | - Steven Daveluy
- Department of Dermatology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
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4
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Chaima K, Fatma H, Nadine K, Chahir K, Emna B, Khadija S, Mariem A, Sonia B, Abderrahman M, Tahya B, Hamida T. Lichen planus pigmentosus post COVID-19-vaccination: A case report with literature review. Dermatol Ther 2022; 35:e15891. [PMID: 36183151 PMCID: PMC9538344 DOI: 10.1111/dth.15891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 09/17/2022] [Accepted: 09/28/2022] [Indexed: 11/30/2022]
Abstract
Lichen planus (LP) is a T cell‐mediated chronic inflammatory disorder. Several clinical variants based on lesion morphology and localization are reported. LPP remains uncommon with an unknown etiology. Besides, some precipitating factors have been suggested in the literature including hepatitis C infection; restrictive underwear, localized friction, and sun exposure.(1, 2) Herein, we present a case of new‐onset of LPP following the ChAdOx1 nCoV‐19 (Oxford‐AstraZeneca) vaccine. A literature review was also conducted to summarize the various cases of LP induced and/or trigged by Covid‐19 vaccine.
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Affiliation(s)
- Kouki Chaima
- Department of Dermatology Hedi Chaker HospitalUniversity of SfaxTunisia
| | - Hammami Fatma
- Department of Dermatology Hedi Chaker HospitalUniversity of SfaxTunisia
| | - Kammoun Nadine
- Department of Dermatology Hedi Chaker HospitalUniversity of SfaxTunisia
| | - Kammoun Chahir
- Department of AnatomopathologyHabib Bourguiba HospitalSfaxTunisia
| | - Bahloul Emna
- Department of Dermatology Hedi Chaker HospitalUniversity of SfaxTunisia
| | - Sellami Khadija
- Department of Dermatology Hedi Chaker HospitalUniversity of SfaxTunisia
| | - Amouri Mariem
- Department of Dermatology Hedi Chaker HospitalUniversity of SfaxTunisia
| | - Boudaya Sonia
- Department of Dermatology Hedi Chaker HospitalUniversity of SfaxTunisia
| | | | - Boudawara Tahya
- Department of AnatomopathologyHabib Bourguiba HospitalSfaxTunisia
| | - Turki Hamida
- Department of Dermatology Hedi Chaker HospitalUniversity of SfaxTunisia
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5
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Shaikh TG, Waseem S, Ahmed SH, Qadir NA, Piccolo V. SARS-CoV-2 Vaccination and Chilblain-like Lesions: What Do We Know so Far? Dermatol Pract Concept 2022; 12:e2022170. [PMID: 36534559 PMCID: PMC9681186 DOI: 10.5826/dpc.1204a170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION The coronavirus pandemic has caused massive damage to global health care and the economy. The vaccination program has been paced around the globe to return as soon as possible to pre-COVID time. Although all the vaccines have been approved after the rigorous clinical and safety trials, some adverse effects have surfaced and are being reported from different parts of the world. One such side effect is chilblain-like lesions following the COVID vaccination. Chilblain lesions, also known as pernio, are an inflammatory condition usually affecting the acral regions of the body. It is mostly reported from cold and damp areas and has multiple causes associated with it. OBJECTIVE This study aims to review the publicly available data and to provide concise and comprehensive information as well as evaluate the potential pathology, clinical approach, and management of CLL post-vaccination. METHODS An extensive literature search over PubMed, Cochrane library, Google Scholar, and Clinicaltrails. gov from inception till 5th October 2021, without any restriction of language was carried out. All the recruited articles were reviewed, and their bibliographies were also screened for any relevant information. RESULTS 12 studies (10 case reports and 2 case series) were retrieved reporting the incidence of CLL post-vaccination. 8 studies reported incidence in female patients while 5 reported in males, with one study mentioning no gender. Moreover, most of them were either from Europe or the United States of America, except for two cases, reported from Turkey. CONCLUSIONS Although the overall incidence of Chilblains following COVID-19 vaccination is low, there is still a strong need to find out the exact mechanism behind this to redefine the safety and administration criteria of the vaccines and to formulate a proper management protocol.
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Affiliation(s)
| | | | | | | | - Vincenzo Piccolo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
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6
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Kato J, Kamiya T, Handa T, Kobayashi E, Hida T, Yamashita T, Uhara H. Linear lichen planus after COVID-19 vaccination. Australas J Dermatol 2022; 63:e385-e387. [PMID: 35877179 PMCID: PMC9349488 DOI: 10.1111/ajd.13902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/09/2022] [Accepted: 07/14/2022] [Indexed: 12/11/2022]
Affiliation(s)
- Junji Kato
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takafumi Kamiya
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiya Handa
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Eri Kobayashi
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tokimasa Hida
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiharu Yamashita
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hisashi Uhara
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
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7
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Washrawirul C, Triwatcharikorn J, Phannajit J, Ullman M, Susantitaphong P, Rerknimitr P. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2022; 36:1947-1968. [PMID: 35666609 PMCID: PMC9348179 DOI: 10.1111/jdv.18294] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/18/2022] [Indexed: 01/08/2023]
Abstract
Although vaccination is widely accepted as an effective method of preventing and controlling the COVID-19 pandemic, many people are concerned about possible cutaneous side effects which can delay or prevent them from being vaccinated. The objectives of this systematic review were to assess the global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination. PubMed and Scopus databases were searched for articles published from January 1, 2019, to December 31, 2021, and reference lists for each selected article were screened. Case reports, case series, observational studies, and randomized controlled trials that provided information on cutaneous adverse reactions following COVID-19 vaccines were included. A total of 300 studies were included in a systematic review of which 32 studies with 946,366 participants were included in the meta-analysis. The pooled prevalence of cutaneous manifestations following COVID-19 vaccination was 3.8% (95% CI, 2.7%-5.3%). COVID-19 vaccines based on the mRNA platform had a higher prevalence than other platforms at 6.9% (95% CI, 3.8%-12.3%). Various cutaneous manifestations have been reported from injection site reactions which were the most common (72.16%) to uncommon adverse reactions such as delayed inflammatory reactions to tissue filler (0.07%) and flares of pre-existing dermatoses (0.07%). Severe cutaneous reactions such as anaphylaxis have also been reported, but in rare cases (0.05%). In conclusion, cutaneous adverse reactions are common, especially in those receiving mRNA vaccines. Most reactions are mild and are not contraindications to subsequent vaccination except for anaphylaxis, which rarely occurs. COVID-19 vaccination may also be associated with flares of pre-existing dermatoses and delayed inflammatory reactions to tissue filler. Patients with a history of allergies, pre-existing skin conditions, or scheduled for filler injections should receive additional pre-counseling and monitoring. A better understanding of potential side effects may strengthen public confidence in those wary of new vaccine technologies.
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Affiliation(s)
- C Washrawirul
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Triwatcharikorn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Phannajit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - M Ullman
- Department of Research Affairs, Chulalongkorn University, Bangkok, Thailand
| | - P Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - P Rerknimitr
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
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8
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Bularca E, Monte‐Serrano J, Villagrasa‐Boli P, Lapeña‐Casado A, de‐la‐Fuente S. Reply to "COVID vaccine-induced lichen planus on areas previously affected by vitiligo". J Eur Acad Dermatol Venereol 2022; 36:e423-e425. [PMID: 35148438 PMCID: PMC9114985 DOI: 10.1111/jdv.18001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- E. Bularca
- Department of DermatologyLozano Blesa University Clinical Hospital of ZaragozaZaragozaSpain
| | - J. Monte‐Serrano
- Department of DermatologyLozano Blesa University Clinical Hospital of ZaragozaZaragozaSpain
| | - P. Villagrasa‐Boli
- Department of DermatologyLozano Blesa University Clinical Hospital of ZaragozaZaragozaSpain
| | - A. Lapeña‐Casado
- Department of DermatologyLozano Blesa University Clinical Hospital of ZaragozaZaragozaSpain
| | - S. de‐la‐Fuente
- Department of DermatologyLozano Blesa University Clinical Hospital of ZaragozaZaragozaSpain
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9
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Hertel M, Schmidt-Westhausen AM, Wendy S, Heiland M, Nahles S, Preissner R, Preissner S. Onset of Oral Lichenoid Lesions and Oral Lichen Planus Following COVID-19 Vaccination: A Retrospective Analysis of about 300,000 Vaccinated Patients. Vaccines (Basel) 2022; 10:vaccines10030480. [PMID: 35335112 PMCID: PMC8951494 DOI: 10.3390/vaccines10030480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 01/14/2023] Open
Abstract
Introduction: Onset of oral lichenoid lesions (OLL) or oral lichen planus (OLP) can be rare adverse reactions to vaccines. Recently, the first solitary cases were reported after COVID-19 vaccination. The aim of the present study was to assess if an increased frequency of OLL/OLP can be found after COVID-19 vaccination within a large real-world cohort. It was assumed that the incidence of OLL/OLP was significantly higher in subjects who received COVID-19 vaccine (cohort I) compared to individuals who were not vaccinated (cohort II). Patients and Methods: Initial cohorts of 274,481 vaccinated and 9,429,892 not vaccinated patients were retrieved from the TriNetX database (TriNetX, Cambridge, Massachusetts, USA), and matched for age, gender and the frequency of use of non-steroidal anti-inflammatory drugs, beta blockers, and angiotensin-converting enzyme inhibitors. Results: After matching each cohort, we accounted for 217,863 patients. Among cohort I, 146 individuals had developed OLL/OLP within 6 days after COVID-19 vaccination (88 and 58 subjects had received mRNA- and adenovirus vector-based vaccines), whereas in cohort II, 59 patients were newly diagnosed with OLL/OLP within 6 days after having visited the clinic for any other reason. The risk of developing OLL/OLP was calculated as 0.067% vs. 0.027%, for cohorts I and II, whereby the risk difference was highly significant (p < 0.001; log-rank test). RR and OR were 2.475 (95% CI = 1.829; 3.348) and 2.476 (95% CI = 1.830; 3.350), respectively. Discussion: The hypothesis was confirmed. Accordingly, the obtained results suggest that the onset of OLL/OLP is a rare adverse drug reaction to COVID-19 vaccines, especially to mRNA vaccines. Thus far, it remains unknown if specific components of the formulations cause a type IV hypersensitive reaction corresponding to OLL, or if the immune response post vaccination triggers a T cell-driven autoimmune reaction directed against the basal layer of keratinocytes of the oral mucosa in terms of OLP. Although OLL and OLP are both classified as premalignant lesions, spontaneous remission may be expected over time, at least in the case of OLL. Therefore, the presented findings should not place any limitation toward the use of COVID-19-vaccines in broad levels of the population.
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Affiliation(s)
- Moritz Hertel
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany; (M.H.); (S.W.); (M.H.); (S.N.)
| | - Andrea-Maria Schmidt-Westhausen
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4–6, 14197 Berlin, Germany;
| | - Stephanie Wendy
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany; (M.H.); (S.W.); (M.H.); (S.N.)
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany; (M.H.); (S.W.); (M.H.); (S.N.)
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany; (M.H.); (S.W.); (M.H.); (S.N.)
| | - Robert Preissner
- Institute of Physiology and Science-IT, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Philippstr. 12, 10115 Berlin, Germany;
| | - Saskia Preissner
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany; (M.H.); (S.W.); (M.H.); (S.N.)
- Correspondence:
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10
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Kaomongkolgit R, Sawangarun W. Oral lichen planus following mRNA COVID-19 vaccination. Oral Dis 2022; 28 Suppl 2:2622-2623. [PMID: 35263820 PMCID: PMC9115415 DOI: 10.1111/odi.14182] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/03/2022] [Indexed: 12/03/2022]
Affiliation(s)
| | - Wanlada Sawangarun
- Department of Oral Diagnosis, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
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11
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Caroppo F, Deotto ML, Tartaglia J, Belloni Fortina A. Vitiligo worsened following the second dose of mRNA SARS-CoV-2 vaccine. Dermatol Ther 2022; 35:e15434. [PMID: 35266259 PMCID: PMC9111845 DOI: 10.1111/dth.15434] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/16/2022] [Accepted: 03/07/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Francesca Caroppo
- Dermatology Unit - Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Maria Ludovica Deotto
- Dermatology Unit - Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Jacopo Tartaglia
- Dermatology Unit - Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Anna Belloni Fortina
- Dermatology Unit - Department of Medicine DIMED, University of Padova, Padova, Italy
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12
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Avallone G, Quaglino P, Cavallo F, Roccuzzo G, Ribero S, Zalaudek I, Conforti C. SARS-CoV-2 vaccine-related cutaneous manifestations: a systematic review. Int J Dermatol 2022; 61:1187-1204. [PMID: 35141881 PMCID: PMC9111829 DOI: 10.1111/ijd.16063] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 12/10/2021] [Accepted: 12/30/2021] [Indexed: 12/14/2022]
Abstract
To date, over 250 million people have been reportedly infected by COVID‐19 disease, which has spread across the globe and led to approximately 5.1 million fatalities. To prevent both COVID‐19 and viral transmission, DNA‐based/RNA‐based vaccines, non‐replicating viral vector vaccines, and inactivated vaccines have been recently developed. However, a precise clinical and histological characterization of SARS‐CoV‐2 vaccine‐related dermatological manifestations is still lacking. A systematic review of 229 articles was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, in order to provide an extensive overview of SARS‐CoV‐2 vaccine‐related skin manifestations. Data on demographics, number of reported cases with cutaneous involvement, vaccine, and rash type (morphology) were extracted from articles and summarized. A total of 5941 SARS‐CoV‐2 vaccine‐related dermatological manifestations were gathered. Local injection‐site reactions were the most frequently observed, followed by rash/unspecified cutaneous eruption, urticarial rashes, angioedema, herpes zoster, morbilliform/maculopapular/erythematous macular eruption, pityriasis rosea and pityriasis rosea‐like eruptions, and other less common dermatological manifestations. Flares of pre‐existing dermatological conditions were also reported. Cutaneous adverse reactions following SARS‐CoV‐2 vaccine administration seem to be heterogeneous, rather infrequent, and not life‐threatening. Vaccinated patients should be monitored for skin manifestations, and dermatological evaluation should be offered, when needed.
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Affiliation(s)
- Gianluca Avallone
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Francesco Cavallo
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Gabriele Roccuzzo
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
| | - Claudio Conforti
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
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13
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Babazadeh A, Miladi R, Barary M, Shirvani M, Ebrahimpour S, Aryanian Z, Mohseni Afshar Z. COVID‐19 vaccine‐related new‐onset lichen planus. Clin Case Rep 2022; 10:e05323. [PMID: 35140945 PMCID: PMC8810943 DOI: 10.1002/ccr3.5323] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/07/2022] [Indexed: 01/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID‐19) vaccines significantly impacted world health and well‐being. However, various adverse events have been observed following severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccination. Cutaneous reactions have been prevalent following many vaccines, including COVID‐19 vaccines. Here, we present a case of new‐onset lichen planus in a patient who received the COVID‐19 vaccine at the same time as being infected with SARS‐CoV‐2. A 52‐year‐old woman presented to the clinic with extensive pruritic skin lesions. The eruptions had appeared a week after her second dose of the Sinopharm COVID‐19 vaccine. She mentioned a history of SARS‐CoV‐2 infection approximately 10 days following the first dose of her vaccine, causing a 1‐month delay in getting the second dose. Her past medical history was not significant. On examination, erythematous and squamous papules were demonstrated predominantly on the extremities, including inguinal and axillary folds. Moreover, desquamation of the lips was visible, and buccal lesions were also found. After consultation with a dermatologist, a skin biopsy was indicated for the patient, but she refused to undergo the procedure. Therefore, considering the typical appearance of the eruptions, lichen planus was suspected, for which she was treated with oral antihistamines and topical corticosteroids. Dermatologists should be aware of the probability of new‐onset or exacerbated mucosal skin disorders due to the vast range of cutaneous adverse events following COVID‐19 vaccination and actively monitor susceptible patients.
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Affiliation(s)
- Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center Health Research Institute Babol University of Medical Sciences Babol Iran
| | - Ronak Miladi
- Clinical Research Development Center Imam Reza Hospital Kermanshah University of Medical Sciences Kermanshah Iran
| | - Mohammad Barary
- Student Research Committee Babol University of Medical Sciences Babol Iran
- Students' Scientific Research Center (SSRC) Tehran University of Medical Sciences Tehran Iran
| | - Maria Shirvani
- Clinical Research Development Center Imam Reza Hospital Kermanshah University of Medical Sciences Kermanshah Iran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center Health Research Institute Babol University of Medical Sciences Babol Iran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center Tehran University of Medical Sciences Tehran Iran
- Department of Dermatology School of Medicine Babol University of Medical Sciences Babol Iran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center Imam Reza Hospital Kermanshah University of Medical Sciences Kermanshah Iran
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14
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Chakraborty A, Reval N, Kamath L. Adverse Events Following COVID-19 Vaccination in Selected Apartments in Bangalore, India. Cureus 2022; 14:e21809. [PMID: 35291520 PMCID: PMC8896841 DOI: 10.7759/cureus.21809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 02/06/2023] Open
Abstract
Background Vaccination has provided a ray of hope in combating the coronavirus disease 2019 (COVID-19). Vaccines were rolled out as an emergency measure, with an expedited approval process. The available clinical trial data reveals the fact that vaccines mostly produce mild adverse events following immunization (AEFIs). Since the experiences are relatively new, it is important to monitor safety in a real-world setting. With this background, this survey was conducted. Methods This cross-sectional study was approved by the institutional ethics committee (IEC) of Vydehi Institute of Medical Sciences and Research Centre. This was conducted over a period of four months at select apartment complexes around Whitefield, Bangalore. The participants were invited to fill up data through online Google Forms (Google, Mountain View, CA, USA). They were requested to provide demographic details, information related to vaccination, and AEFIs. Eligibility to participate included recipients of vaccines who received Emergency Use Authorization (EUA) in India. Data were analyzed using SPSS version 20.00 (IBM Corporation, Armonk, NY, USA). Results The total number of participants in the study was 322. Out of this, 37.6% (121) were males and 62.4% (201) were females. The mean age of the participants was 34.9 ± 12.4 (mean ± standard deviation (SD) years. About 30% (96) of the study participants had comorbidities. Overall, 67.4% (217) of the participants suffered from AEFI. Of them, immediate reactions were reported by 18.3% (59) and 10.2% (32) of the participants after the first and second doses, respectively. A total of 0.9% (3) of the participants had immediate allergic reactions. The most common local and systemic AEFIs were pain at the injection site and extreme tiredness. AEFIs were found to be mild and with a probable association with vaccination as per the WHO scale. The number of females experiencing AEFIs was found to be higher when compared with males for both local and systemic reactions. There was a statistically significant increase in the number of individuals experiencing general adverse effects following the first dose of CovishieldTM (Serum Institute of India Private Limited, Pune, India) when compared with CovaxinTM (Bharat Biotech Limited, Hyderabad, India) (P < 0.05). Of the participants, 5.9% (19) were diagnosed with COVID-19 post-vaccination. Among them, 15.8% (3) required hospitalization, with 10.5% (2) of them requiring an oxygen bed. It was observed that 76.5% (166) of the participants did not report their reactions to concerned authorities. Conclusion Based on our sample, the study reflects that COVID-19 vaccination causes mild AEFI in most vaccine recipients. It also provides an insight that reporting of AEFI is very low. It is, therefore, important to take up more awareness campaigns about reporting of AEFIs through the COVID Vaccine Intelligence Network (CoWIN) portal.
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Affiliation(s)
- Ananya Chakraborty
- Pharmacology and Therapeutics, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
| | - Nishith Reval
- Pharmacology and Therapeutics, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
| | - Latha Kamath
- Pharmacology and Therapeutics, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
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15
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Piccolo V, Russo T, Mazzatenta C, Bassi A, Argenziano G, Cutrone M, Danielsson Darlington M, Grimalt R. COVID vaccine-induced pustular psoriasis in patients with previous plaque type psoriasis. J Eur Acad Dermatol Venereol 2022; 36:e330-e332. [PMID: 35015916 DOI: 10.1111/jdv.17918] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/05/2022] [Indexed: 11/27/2022]
Affiliation(s)
| | - Teresa Russo
- Dermatology Unit University of Campania, Naples, Italy
| | | | - Andrea Bassi
- UO Dermatology- Azienda USL Toscana Nord Ovest, Lucca, Italy
| | | | - Mario Cutrone
- Pediatric Dermatology, Ospedale dell'Angelo Venezia, Ospedale San Bortolo Vicenza
| | - Markus Danielsson Darlington
- Department of Dermatology, Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Ramon Grimalt
- International University of Catalunya, Barcelona, Spain
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16
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Awada B, Abdullah L, Kurban M, Abbas O. Inverse lichen planus post Oxford-AstraZeneca COVID-19 vaccine. J Cosmet Dermatol 2022; 21:883-885. [PMID: 34997985 DOI: 10.1111/jocd.14738] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/07/2021] [Accepted: 12/29/2021] [Indexed: 01/05/2023]
Affiliation(s)
- Bassem Awada
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Lina Abdullah
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Mazen Kurban
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Ossama Abbas
- American University of Beirut Medical Center, Beirut, Lebanon.,Faruk Medical City, Sulaymaniyah, Iraq
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17
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Baba A, Kanekura T, Tsubouchi H. Lichenoid drug eruption after coronavirus disease 2019 vaccination. J Dermatol 2021; 49:e159-e160. [PMID: 34961975 DOI: 10.1111/1346-8138.16294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Atsunori Baba
- Department of Dermatology, Kagoshima City Hospital, Kagoshima, Japan
| | - Takuro Kanekura
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hirohito Tsubouchi
- Department of Gastroenterology, Kagoshima City Hospital, Kagoshima, Japan
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18
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Diab R, Araghi F, Gheisari M, Asadi Kani Z, Moravvej H. Lichen planus and Lichen planopilaris flare after COVID-19 vaccination. Dermatol Ther 2021; 35:e15283. [PMID: 34953018 DOI: 10.1111/dth.15283] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/29/2022]
Abstract
We report two cases of lichen planus following COVID-19 vaccination in two middle-aged women, where the first patient presented with lichenplanopilaris (LPP) relapse and development of lichen planus fourteen days after the second dose of AstraZeneca vaccine, and the other patient who had a previous scattered lesion of LP which extended and increased in severity after the first and second dose of Sinopharm. The suggested cause could be due to immune dysregulation and up regulation of T cell lymphocytes which was triggered after COVID-19 vaccination. What supports our hypothesis that LP had occurred due to COVID-19 vaccination, is that one of the patients responded successfully to Metronidazole. This means that the infection process after vaccination could be the cause in aggravating LP. To add, one of the suggested mechanisms for the appearance of LP or reactivation of a dormant LPP can be cytotoxic CD8 T-lymphocytes which increase the secretion of IFN-γ and IL-5 cytokines and may also result in basal keratinocytes' apoptosis leading to cutaneous manifestations. This was supported by the efficacy of Tofacitinib that was used in the other patient who presented with reactivation of LPP in addition to LP. Tofacitinib decrease the number of T cell infiltration and adjust IFN expression. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Reem Diab
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnaz Araghi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Gheisari
- Department of Dermatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Asadi Kani
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Moravvej
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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19
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Masseran C, Cӑlugӑreanu A, Caux F, Bohelay G. Extensive cutaneous lichen planus triggered by viral vector COVID-19 vaccination (ChAdOx1 nCoV-19). J Eur Acad Dermatol Venereol 2021; 36:e263-e265. [PMID: 34936145 DOI: 10.1111/jdv.17899] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Clémence Masseran
- Department of Dermatology, Groupe Hospitalier Paris-Seine-Saint-Denis, AP-HP, Bobigny, France
| | | | - Frédéric Caux
- Department of Dermatology, Groupe Hospitalier Paris-Seine-Saint-Denis, AP-HP, Bobigny, France.,INSERM, UMR 1125, Université Sorbonne Paris Nord, LI2P, Bobigny, France
| | - Gérôme Bohelay
- INSERM, UMR 1125, Université Sorbonne Paris Nord, LI2P, Bobigny, France
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20
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Tatu AL, Nadasdy T, Nwabudike LC. Koebner phenomenon with lichen planus in an area of previous vitiligo after COVID-19 vaccination and the creation of a locus minoris resistentiae. J Eur Acad Dermatol Venereol 2021; 36:e265-e266. [PMID: 34897823 DOI: 10.1111/jdv.17864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/03/2021] [Indexed: 01/12/2023]
Affiliation(s)
- A L Tatu
- Dermatology Department, "St. Parascheva" Clinical Hospital of Infectious Diseases, Galati, Romania.,Faculty of Medicine and Pharmacy/Clinical Department, Dermatology, Medical and Pharmaceutical Research Unit/Competitive, Interdisciplinary Research Integrated Platform, ReForm-UDJG "Dunărea de Jos" University, Galati, Romania
| | - T Nadasdy
- Dermatology Department, "St. Parascheva" Clinical Hospital of Infectious Diseases, Galati, Romania
| | - L C Nwabudike
- N. Paulescu National Institute of Diabetes, Bucharest, Romania
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