Hepatitis B vaccination and associated oral manifestations: a non-systematic review of literature and case reports

Oral and non-oral lichen planus show genetic heterogeneity and differential risk for autoimmune disease and oral cancer

Lichen planus (LP) is a T-cell-mediated inflammatory disease affecting squamous epithelia in many parts of the body, most often the skin and oral mucosa. Cutaneous LP is usually transient and oral LP (OLP) is most often chronic, so we performed a large-scale genetic and epidemiological study of LP to address whether the oral and non-oral subgroups have shared or distinct underlying pathologies and their overlap with autoimmune disease. Using lifelong records covering diagnoses, procedures, and clinic identity from 473,580 individuals in the FinnGen study, genome-wide association analyses were conducted on carefully constructed subcategories of OLP (n = 3,323) and non-oral LP (n = 4,356) and on the combined group. We identified 15 genome-wide significant associations in FinnGen and an additional 12 when meta-analyzed with UKBB (27 independent associations at 25 distinct genomic locations), most of which are shared between oral and non-oral LP. Many associations coincide with known autoimmune disease loci, consistent with the epidemiologic enrichment of LP with hypothyroidism and other autoimmune diseases. Notably, a third of the FinnGen associations demonstrate significant differences between OLP and non-OLP. We also observed a 13.6-fold risk for tongue cancer and an elevated risk for other oral cancers in OLP, in agreement with earlier reports that connect LP with higher cancer incidence. In addition to a large-scale dissection of LP genetics and comorbidities, our study demonstrates the use of comprehensive, multidimensional health registry data to address outstanding clinical questions and reveal underlying biological mechanisms in common but understudied diseases.

COVID 19 vaccination as a trigger of acute genital ulcers in an immunocompromised adolescent-case study and literature review

Acute genital ulcers can affect females of all ages. In children, they often appear as an emergency and remain a diagnostic challenge for pediatricians, gynecologists and dermatologists. Prompt diagnosis and identification of disease- related factors help to implement appropriate treatment. Firstly, it is crucial to properly compile the past medical history of the patient. Past infectious, autoimmune, malignant or traumatic conditions, as well as vaccinations may contribute to the occurrence of acute genital ulcers. Moreover, new infectious agents, such as severe acute respiratory syndrome coronavirus 2 and vaccinations against Coronavirus disease of 2019, may play a significant role in the development of atypical clinical symptoms. Here we present a case of a 12-year-old girl with acute genital ulcers. Additional symptoms accompanying the ulcer included: abdominal pain, nausea, vomiting, dysuria, vulvar pain and fever. Blood test showed leukocytosis, especially neutrophilia and monocytosis and increased levels of c-reactive protein and procalcitonin. Serological tests for the most common infections were negative. Moreover, the patient had a history of autoimmune diseases. She had periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome, and IgA vasculitis, also known as Henoch-Schönlein purpura in her past medical history. Additionally, she was vaccinated against SARS-CoV-2 shortly before the lesions appeared.

A comprehensive review of oral microenvironment changes and orofacial adverse reactions after COVID-19 vaccination: The good, the bad, and the ugly

BACKGROUND AND AIMS

Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines have the potential to alter several biological systems concurrently with remolding the immune system, most of which are related to immunization, while some others are known as adverse effects. This review aims to explore the potential effects of vaccination on the oral microenvironment and classifies them as good, bad, or ugly, with a brief review of facial diseases following coronavirus disease 2019 (COVID-19) vaccination.

METHODS

This study was a comprehensive review conducted through searching related articles in Medline, Scopus, and Google Scholar databases.

RESULTS

On one side, the "Good" impacts of vaccination on the oro-nasal mucosa are explained as if the mucosal immune responses followed by SARS-CoV-2 vaccines are enough to provide immunity. On the other side, the possible "Bad" and "Ugly" effects of the vaccine, which manifest as orofacial adverse events and autoimmune reactivations, respectively, should be noted. Exacerbation of pre-existing autoimmune conditions such as lichen planus, pemphigus vulgaris, bullous pemphigoid, and Stevens-Johnson syndrome have been reported.

CONCLUSION

COVID-19 vaccines could affect different biological systems alongside stimulating the immune system, and some of these effects are referred to as adverse effects. Nonetheless, these adverse effects are treatable, and healthcare professionals should not prevent patients from taking the first available vaccination.

Oral lichen planus and lichenoid lesions - challenges and pitfalls for the general dental practitioner

Lichen planus is a chronic, mucocutaneous inflammatory condition which, due to its prevalence, will be familiar to the dental profession. However, diverse forms of presentation, important differential diagnosis, potential malignant change and monitoring requirements often result in challenges for those in primary care. This paper looks to examine these challenges and provide information to support those who are involved in recognition and management of patients with lichen planus.

Vulvar Aphthous Ulcer Following Pfizer-BioNTech COVID-19 Vaccine - A Case Report

BACKGROUND

In this case report, we describe a potential association between the Pfizer-BioNTech COVID-19 vaccine and development of a vulvar aphthous ulcer in a virginal 14-year-old girl.

CASE

A 14-year-old patient reported vulvar pain and visible lesion. Exam findings were consistent with vulvar aphthous ulcers. Two days prior to the onset of her symptoms she received her second Pfizer-BioNTech COVID-19 vaccine. The evening of vaccine administration, she experienced several hours duration of fatigue, muscle aching and insomnia but had otherwise been recently healthy and testing for common viral associations of vulvar ulcers was negative.

SUMMARY AND CONCLUSION

Vaccination, in general, has been associated with mucosal side-effects and oral ulceration has been reported in subjects who received Pfizer-BioNTech COVID-19 vaccine. It is reasonable to hypothesize that vulvar ulceration may be caused by a similar mechanism and should be considered a rare side effect of this vaccine.

Safety of ChAdOx1 nCoV-19 Vaccine: Independent Evidence from Two EU States

Recent reports of thrombosis following AstraZeneca COVID-19 vaccine in young females (<55 years-old) led to temporary suspension and urgent investigation by the European Medicines Agency (EMA) that concluded that vaccine benefits still outweigh its side effects (SEs). Therefore, this study aims to provide early independent evidence on the vaccine SEs’ prevalence and their potential risk factors; a cross-sectional survey-based study was carried out between February and March 2021 in Germany and Czech Republic among healthcare workers who recently received the AstraZeneca COVID-19 vaccine. The study used a validated self-administered questionnaire composed of twenty-eight multiple-choice items covering demographic variables, medical anamneses, and local, systemic, oral, and skin related SEs of the vaccine. Out of the ninety-two included participants, 77.2% were females and 79.3% were from Germany. Their mean age was 35.37 ± 12.62 (19–64) years-old, 15.2% had chronic illnesses and 22.8% were receiving medical treatments. Overall, 94.6% of the participants reported at least one SE. The most common local SE was injection site pain (72.8%), and the most common systemic SEs were fatigue (73.9%), muscle pain (55.4%), chills (48.9%), feeling unwell (46.7%), nausea (45.7%), and headache (29.3%). The vast majority (91.9%) resolved within 1–3 days, and the below 35 years-old group was the least affected age group. The SEs’ frequency was insignificantly higher in females and previously infected participants; the vaccine safety for the elderly was supported by the early findings of this study. Chronic illnesses and medical treatments were not associated with an increased risk of SE incidence and frequency. No blood disorder SEs were reported in our sample. Further independent studies are highly required to evaluate the safety of the AstraZeneca vaccine and to explore whether gender or previous infection could be associated with the vaccine SEs.

Facial and Oral Manifestations Following COVID-19 Vaccination: A Survey-Based Study and a First Perspective

(1) Background: Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) emerged in Wuhan, China, in late 2019. The development of effective and safe vaccines against SARS-CoV-2 has been extremely fast. The list of orofacial adverse effects of BNT162b2 and mRNA-1273 vaccines based on the clinical trials are reported to be rare. The aim of this study was to investigate the facial and oral manifestations of COVID-19 vaccination using a survey-based study. (2) Methods: The questionnaire was developed using Google Forms and sent anonymously to a total of 700 subjects (medical personnel) in Poland, Italy, and other EU countries. (3) Results: 223 people answered the questionnaire, mainly vaccinated with BNT162b2. Only 3.1% and 5.4% experienced oral and facial symptoms, respectively. General diseases presence and age have significant influence on the probability of oral symptoms occurrence after the second dose. Facial symptoms are correlated with general disease; autoimmune pathologies and age, at first and second dose, respectively. Gender, smoking and regular medication intake have significant influence on the probability of taking an absence day. Gender, age, and smoking have a significant influence on the duration of symptoms after second dose. (4) Conclusions: Based on the results of this preliminary survey, there is no observed significant correlation between vaccine administration for COVID-19 and facial and oral manifestations.

Prevalence of COVID-19 Vaccine Side Effects among Healthcare Workers in the Czech Republic

Background: COVID-19 vaccine side effects have a fundamental role in public confidence in the vaccine and its uptake process. Thus far, the evidence on vaccine safety has exclusively been obtained from the manufacturer-sponsored studies; therefore, this study was designed to provide independent evidence on Pfizer–BioNTech COVID-19 vaccine side effects. Methods: A cross-sectional survey-based study was carried out between January and February 2021 to collect data on the side effects following the COVID-19 vaccine among healthcare workers in the Czech Republic. The study used a validated questionnaire with twenty-eight multiple-choice items covering the participants’ demographic data, medical anamneses, COVID-19-related anamneses, general, oral, and skin-related side effects. Results: Injection site pain (89.8%), fatigue (62.2%), headache (45.6%), muscle pain (37.1%), and chills (33.9%) were the most commonly reported side effects. All the general side effects were more prevalent among the ≤43-year-old group, and their duration was mainly one day (45.1%) or three days (35.8%) following the vaccine. Antihistamines were the most common drugs associated with side effects, thus requiring further investigation. The people with two doses were generally associated with a higher frequency of side effects. Conclusions: The distribution of side effects among Czech healthcare workers was highly consistent with the manufacturer’s data, especially in terms of their association with the younger age group and the second dose. The overall prevalence of some local and systemic side effects was higher than the manufacturer’s report. Further independent studies on vaccine safety are strongly required to strengthen public confidence in the vaccine.