Lichen planus after COVID-19 infection and vaccination

Background: 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. Method(s): Literature searches were conducted on PubMed and Google Scholar from 2019 to 7/2022. 35 articles were selected based on subject relevance, and references within articles were also screened. Result(s): 39 cases of post-vaccination LP and 6 cases of post-infection LP were found among case reports and case series. 150 cases of postvaccination LP and 12 cases of post-infection LP were found in retrospective and prospective studies. Conclusion(s): 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.

Dermatological Manifestations in COVID-19 and Post COVID-19 Patients: An Observational Study

Background: In December 2019, a new infection termed severe acute respiratory syndrome coronavirus 2 was recognised in Wuhan China. In literature only few studies exist on cutaneous manifestations in COVID-19 and post-COVID-19 phase. Hence the present study is conducted to know the most common cutaneous manifestations. Material(s) and Method(s): The present study included total of 60 patients presented with skin manifestations during COVID-19 and post COVID-19 phase of both in-patients and out-patients from October 2020 to June 2021. The patients aged more than 18yrs, tested positive for SARS CoV2 with dermatological manifestation during the infection and 3wks after testing negative for SARS CoV2 up to 3 months were included. The dermatological manifestations were recorded during the active COVID-19 infection and during post-COVID-19 period. Result(s): Among the 60 patients the common pattern was maculopapular rash in 24 patients (40%), urticaria seen in 8 patients (13.3%), chilblain seen in 4 patients (6.66%) and livedo reticularis seen in 2 patient (3.33%), during post COVID-19 were acneiform eruption seen in 16 patients (26.4%), vesicular lesions seen in 4 patients (6.66%) and lichen plan us observed in 2 patients (3.33%). Conclusion(s): There is significant association of presence of the dermatological manifestations among the patients with COVID-19 and post COVID-19 period. Study of these dermatological manifestations and their pathogenesis and their significance in human health is useful in avoiding misdiagnosis and proper treatment.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Lichen planus occuring after Coronavirus disease-2019: A case report

The novel Coronavirus disease-2019 (COVID-19), which emerged in December 2019 and caused an unexplained viral pneumonia, rapidly spread worldwide within a few months. A pandemic was declared by the World Health Organization in March 2020. Several cutaneous manifestations of the disease among patients with COVID-19 have been reported. Thus far, the most frequently reported cutaneous findings are morbiliform rash, urticarial lesions, purpuric lesions, oral vesicles, and pityriasis rosea. This report presents a case of lichen planus secondary to COVID-19 and its histopathological findings, which is rarely reported in the literature. Copyright © 2022 by Turkish Society of Dermatology and Venereology.

Effect of SARS CoV-2 Infection on Periodontal Tissue: A Systematic Review

Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infection in human respiratory cells. The first spread of this disease first occurred in Wuhan, China, in December 2019, and on March 11, 2020, the World Health Organization declared the spread of the infection as a global pandemic. People who are infected experience mild to moderate clinical symptoms which are characterized by an increase in T cell, CD8, and IgM/IgG levels. The occurrence of severe clinical symptoms reflects an excessive and uncontrolled increase in the secretion of pro-inflammatory cytokines, which impacts the systemic condition and periodontal tissues of affected patients. Objective(s): The aim of this study is to describe the impact of SARS CoV-2 infection on periodontal tissues. Method(s): In this study, we searched the NCBI, PubMed, Google Scholar, and Research Gate databases. The keywords used were "coronavirus disease" o"COVID-19" or "SARS-CoV-2" with "oral manifestations" and "periodontal," and we screened the articles using the PRISMA flow diagram. Result(s): Patients with COVID-19 present with a variety of systemic symptoms, as well as manifestations in the periodontal tissues, especially in the gingival area. Conclusion(s): SARS CoV-2 infection can impact periodontal tissues in the form of necrotizing ulcerative gingivitis, aphthous stomatitis, gingivahyperpigmentation, edema and erythema, lichen planus, and aphthous-like ulcers.Copyright © 2023 Karyadi et al.

Lichen planus after COVID-19 infection and vaccination.

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.

Comprehensive Insight into Lichen Planus Immunopathogenesis.

Lichen planus is a chronic disease affecting the skin, appendages, and mucous membranes. A cutaneous lichen planus is a rare disease occurring in less than 1% of the general population, while oral illness is up to five times more prevalent; still, both forms equally impair the patient's quality of life. The etiology of lichen planus is not entirely understood. Yet, immune-mediated mechanisms have been recognized since environmental factors such as hepatitis virus infection, mechanical trauma, psychological stress, or microbiome changes can trigger the disease in genetically susceptible individuals. According to current understanding, lichen planus immunopathogenesis is caused by cell-mediated cytotoxicity, particularly cytotoxic T lymphocytes, whose activity is further influenced by Th1 and IL-23/Th-17 axis. However, other immunocytes and inflammatory pathways complement these mechanisms. This paper presents a comprehensive insight into the actual knowledge about lichen planus, with the causal genetic and environmental factors being discussed, the immunopathogenesis described, and the principal effectors of its inflammatory circuits identified.

COVID-19 Vaccine-Induced Lichenoid Eruptions-Clinical and Histopathologic Spectrum in a Case Series of Fifteen Patients with Review of the Literature.

Lichen planus is a distinctive mucocutaneous disease with well-established clinical and histopathologic criteria. Lichenoid eruptions closely resemble lichen planus and may sometimes be indistinguishable from it. Systemic agents previously associated have included medications, viral infections and vaccines. Sporadic case reports of lichen planus and lichenoid reactions associated with COVID-19 vaccines have recently emerged. Herein, we review the world literature (31 patients) and expand it with a case series of 15 patients who presented with vaccine-induced lichenoid eruption (V-ILE). The spectrum of clinical and histopathologic findings is discussed with emphasis on the subset whose lesions manifested in embryologic fusion lines termed lines of Blaschko. This rare Blaschkoid distribution appeared in seven of the 46 patients studied. Of interest, all seven were linked to the mRNA COVID-19 vaccines. We believe that all lichenoid eruptions should be approached with a heightened index of suspicion and patients should be specifically questioned with regards to their vaccination history. When diagnosed early in its course, V-ILE is easily treated and resolves quickly in almost all patients with or without hyperpigmentation. Additional investigative studies regarding its immunopathology and inflammatory signaling pathways may offer insight into other Th1-driven autoimmune phenomena related to COVID-19 vaccination.

Adverse cutaneous reactions post Covid-19 vaccination- Case series from a tertiary care centre in Eastern India

Background Since the advent of the novel coronavirus, vaccines have been the most important tool of combat against the raging pandemic. However, several reports of adverse effects following vaccinations including dermatological reactions have emerged. Methods A descriptive observational study was carried out from June to August 2021 with all patients who presented with a new onset cutaneous reaction within 14 days of vaccination excluding patients with other possible causes of cutaneous reaction, particularly exposure to any drugs. Results A series of 13 cutaneous reactions post vaccination with the two major vaccines available in India, Covishiled and Covaxin have been reported in this series. Most of the reactions were mild and included urticaria, pityriasis rosea, morbilliform rash, whereas some uncommon reactions such as lichen planus and vitiligo were found. Severe reactions were rare, only one case of erythema multiforme major was seen. Conclusion The pathophysiology of post vaccination cutaneous reaction is still elusive and warrants further research. It is important for the dermatologist to be aware of such adverse events in order to address the common misconceptions and apprehension of people regarding vaccination. Copyright © 2023 Pakistan Association of Dermatologists. All rights reserved.

Plant Extracts and Phytochemicals, a Promising Strategy Against Oral Lichen Planus: a review on Clinical Trials.

BACKGROUND: Oral lichen planus (OLP) is an autoimmune disease that distress keratinized cells of the oral epithelium. Topical corticosteroids and other potential therapies like immunosuppressives, hydroxychloroquine, azathioprine, mycophenolate, dapsone, retinoids, biologic agents are used for the management of OLP. However, their effectiveness, best dose, duration of treatment and safety remain mostly unidentified. Moreover, recurrence of disease and dose-related side effects are the other issues. OBJECTIVE: The primary objective of the review is to explore the existing clinical trials for the efficacy of phytochemicals in treating OLP in comparison to corticosteroids. A comprehensive information about their mode of action is also discussed. METHOD: We have discussed different clinical trials conducted on various phytochemicals and plant extracts/formulations like curcumin, lycopene, quercetin, glycyrrhizin, purslane, raspberry, aloe vera gel and aloe vera mouthwash for the treatment of OLP. RESULT: The current therapy for the management of OLP has numerous adverse effects and requires a long-term treatment. Phytochemicals can be a very good alternative in overcoming these side effects and reducing the course of treatment. CONCLUSION: Herbal extracts and their formulations can be an effective alternative to the current therapy due to their proven therapeutic effects, reduced side effects, long-term applicability, prevention of recurrence as well as progression into cancer.

Clinical manifestations of oral mucosa lesions in patients with SARS-CoV-2 infection

BACKGROUND: Due to Coronavirus disease, several body systems are involved, and, in the most severe cases, there may be a multiorgan disfunction. The general symptoms can be associated with lesions of the oral cavity. Among these the most reported are ulcerative lesions, together with vesicles and blisters, petechiae, and erythema multiforme-like lesions, aphthous-like lesions, herpetiform lesions and they typically appear at the same time as general symptoms or within one week. The aim of this study was to describe oral lesions observed in 41 Armenian patients with SARS-CoV-2 infection. METHODS: During the period of April 2020-January 2021, 43 patients aged 25 to 51 years positive for COVID-19 test were referred for a full oral mouth examination and diagnosis at Nord KS dental clinic. RESULTS: Of the 18 patients who were already diagnosed with SARS-CoV-2 infection at the time of the visit, 66.6% presented ulcerative lesions;in this group also Candida Albicans infection and lichenoid lesion were diagnosticated. 29 patients were suspected to be positive for COVID-19 and 23 tested positive. In this group of patient periodontal altera-tions relatable to hyperemia, gingival cyanosis and vascular dilation were the most frequently encountered manifesta-tions.CONCLUSIONS: Our study shows how the type of oral lesions during COVID-19 can be related to a determinate phase of the clinical progression: in the first stage of disease oral lesions could be an early sign of infection and during the full-blown phase of this disease they could be clinical manifestation of vasculitic and thrombotic phenomena responsible of COVID-19 complications. The role played by the oral examination in patients with COVID-19 is important in order to raise the suspicion of infection early and to monitor and improve the state of oral health and painful symptoms, in the event of the appearance of more disabling lesions.

Two Cases of New-Onset Lichen Planus Following BNT162b2 mRNA COVID-19 Vaccine

Various cutaneous side effects have been reported to be observed following coronavirus disease-2019 (COVID-19) vaccination. Urticaria, maculopapular eruption, vasculitis, pityriasis rosea, psoriasis and papulovesicular exanthem are some dermatological diseases which are observed after COVID-19 vaccination. Hyperinflammatory environment resulting from the cytokine storm in the setting of COVID-19, immune complex deposition and direct cytopathic effects of the virus are implicated in the etiopathogenesis of the dermatological manifestations. Infectious agents, immunologic factors, vaccinations and drugs have all been blamed in the emergence of lichen planus. With the cases presented in this case report, we would like underline that new-onset cutaneous lichen planus may be seen after mRNA COVID-19 vaccination. Copyright © 2022 by Turkiye Klinikleri.

Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus-Challenges in the Diagnosis and Treatment.

Desquamative gingivitis (DG) is a clinical term that describes erythema, desquamation and erosions of the gingiva, of various etiologies. Although the clinical aspect is not specific for a certain disease, an accurate diagnosis of the underlying disorder is necessary because the disease course, prognosis and treatment vary according to the cause. DG may inflict significant oral discomfort, which is why patients typically present to the dentist for a first consultation, rendering it important for these specialists to be informed about this condition. Our paper aims to review the ethiopatogenesis and diagnostic approach of DG, focusing on the most common underlying disorders (autoimmune bullous dermatoses and lichen planus) and on the management of these patients. Potential etiological agents leading to an inflammatory immune response in the oral mucosa and DG appearance include genetic predisposition, metabolic, neuropsychiatric, infectious factors, medication, dental materials, graft-versus-host reaction and autoimmunity. A thorough anamnesis, a careful clinical examination, paraclinical explorations including histopathological exam and direct immunofluorescence are necessary to formulate an appropriate diagnosis. Proper and prompt management of these patients lead to a better prognosis and improved quality of life, and must include management in the dental office with sanitizing the oral cavity, instructing the patient for rigorous oral hygiene, periodic follow-up for bacterial plaque detection and removal, as well as topical and systemic therapy depending on the underlying disorder, based on treatment algorithms. A multidisciplinary approach for the diagnosis and follow-up of DG in the context of pemphigus vulgaris, bullous pemphigoid, cicatricial pemhigoid or lichen planus is necessary, including consultations with dermatologists, oral medicine specialists and dentists.