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1.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche ; 181(9):610-615, 2022.
Article in English | Web of Science | ID: covidwho-2205184

ABSTRACT

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.

2.
Turkiye Klinikleri Dermatoloji ; 32(3):184-186, 2022.
Article in English | EMBASE | ID: covidwho-2164090

ABSTRACT

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.

3.
Arch Dermatol Res ; 2022.
Article in English | PubMed | ID: covidwho-2148769

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.

4.
Dermatology Online Journal ; 28(5) (no pagination), 2022.
Article in English | EMBASE | ID: covidwho-2144661
8.
Diagnostics (Basel) ; 12(7)2022 Jul 20.
Article in English | MEDLINE | ID: covidwho-1979156

ABSTRACT

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.

9.
Sexually Transmitted Infections ; 98:A35-A36, 2022.
Article in English | EMBASE | ID: covidwho-1956910

ABSTRACT

Introduction A spectrum of skin reactions following mRNA COVID vaccinations have been reported that can mimic dermatological manifestations of Human Immunodeficiency Virus (HIV) infection. Case Description A 47-year-old Zimbabwean female living with HIV since 2011 (nadir CD4 366 cells/mm3) was seen in our HIV clinic with a widespread rash and raised, itchy lesions over her body measuring approximately 5-7mm which appeared three weeks after her first Pfizer-BioNTech COVID-19 vaccine. There was no systemic involvement. Her CD4 count was 641 cells/mm3 (44%) with a fully suppressed viral load on antiretroviral therapy since June 2015 with no other pertinent medical history. There was no response to topical anti-fungal therapy but symptomatic relief with anti-pruritic and anti-histamine was noted. Treatment with oral erythromycin 500mg four times a day for two weeks decreased the size of the lesions and improved the rash. A punch biopsy of pale brown skin at this time was performed with appearances in keeping with those of a lichenoid pattern of inflammation. Our patient continues to improve with erythromycin.Topical or systemic corticosteroid therapy can be considered to further ameliorate her condition. Discussion Lichenoid drug eruptions are well recognized. Our case demonstrates such a reaction to the Pfizer-BioNTech COVID-19 vaccination which adds to cases described in the contemporary medical literature. It is vital to recognize this complication in our specialty as lesions may mimic lichen planus clinically and histologically and may be mistaken for dermatological manifestations associated with HIV, including Kaposi Sarcoma (KS) and bacillary angiomatosis, which can manifest regardless of immune status.

10.
British Journal of Dermatology ; 186(6):e250, 2022.
Article in English | EMBASE | ID: covidwho-1956695

ABSTRACT

While our knowledge about the short-term side-effects of COVID-19 vaccination in adults has rapidly evolved, data about the long-term systemic side-effects and potential new onset autoimmune disorders has been limited. Here we present a case series of patients with new onset autoimmune skin conditions between 10 days and 4 weeks post mRNA COVID-19 vaccination and discuss the underlying pathophysiological changes contributing to these side-effects. Exclusions included any patients who have previously tested positive for COVID-19 or had COVID-19 symptoms. Our cases include new onset discoid lupus, localized cutaneous lupus, dermatomyositis, linear IgA bullous disease, pemphigus vulgaris, bullous pemphigoid, lichen planus pemphigoides, erosive lichen planus, psoriasis and vitiligo. In addition, we are reporting significant flare-up of pre-existing autoimmune skin conditions after a long period of remission. These include three cases of psoriasis, two cases of systemic lupus, one pemphigus vulgaris koebnerizing within a previous shingles site, and a case of pyoderma gangrenosum flare. The BNT162b2 vaccine is a potent activator of the T- and B-cell pathways. The production of interleukin (IL)-17 and IL- 21 seems to play an important role in vaccine-induced immunological protection, which is also linked to germinal centre activation linked to autoimmune disorders. This report improves our knowledge regarding some rarer potential sideeffects associated with these new vaccines and highlights the importance of further studies.

11.
Recent Pat Biotechnol ; 2022 Jul 18.
Article in English | MEDLINE | ID: covidwho-1951889

ABSTRACT

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.

12.
Acta Dermatovenerologica Croatica ; 30(1):40-48, 2022.
Article in English | EMBASE | ID: covidwho-1935139

ABSTRACT

The purpose of this study was to assess how skin biopsy results from adults, which occupy an important place in dermatological practice, have been affected by the COVID-19 pandemic. Adult patients aged over 18 presenting to the dermatology clinical of a tertiary hospital between March 12, 2019 and March 11, 2020, and between March 12, 2020 and March 11, 2021, from whom skin biopsies had been taken and who had undergone pathological examination were included in the study. Pre-COVID-19 pandemic data were compared with post-pandemic data. No significant difference was determined between the two periods in terms of age, sex, type of biopsy, preliminary diagnosis numbers, or clinicopathological correlation (P>0.05). The diseases most frequently diagnosed through biopsy before the pandemic were psoriasis (13.7%), pseudopelade of Brocq (6.8%), and fibroepithelial polyp (5.5%), compared with psoriasis (9.4%), basal cell carcinoma (BCC) (6.3%), lichen planus (6.3%), and urticarial vasculitis (6.3%) during the pandemic. Diagnoses of BCC and urticarial vasculitis were significantly elevated after the COVID-19 pandemic (P<0.05), while no periodic difference was observed in other diagnoses. A rise in the incidence of various diseases, such as urticarial vasculitis, may be indicative of a risk of asymptomatic COVID-19. Further polymerase chain reaction and/or antibody-based investigations should be carried out in order to establish whether dermatological diseases are associated with asymptomatic COVID-19 cases. Determining the clinical and histopathological aspects of COVID-19, which can progress with various cutaneous findings, will be useful in the early diagnosis and treatment of this novel and life-threatening disease.

13.
TURKDERM-TURKISH ARCHIVES OF DERMATOLOGY AND VENEROLOGY ; 56(2):88-90, 2022.
Article in English | Web of Science | ID: covidwho-1939269

ABSTRACT

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.

14.
Journal of Dermatology and Dermatologic Surgery ; 26(1):57-60, 2022.
Article in English | EMBASE | ID: covidwho-1939209

ABSTRACT

Lichen planus is a T-cell-mediated inflammatory disease that can be associated with preexposure to particular agents encompassing vaccines, viruses, and drugs. The origin of the disease is unknown and has varying clinical presentations, the recent manufactured COVID-19 vaccines have been linked with several cutaneous reactions that are similar to the cutaneous manifestations of COVID-19 virus infection, the majority of people developed cutaneous manifestations after the second dose of Pfizer vaccine, recent cases have been reported as a flare of a preexisting lichen planus following the administering of the Pfizer vaccine. We present a two interesting cases that developed a dermatological condition post Pfizer-BioNTech's COVID-19 vaccine. The first case is a 60-year-old man, with a past medical history of having lichen planus 15 years ago, that have been treated and controlled successfully with topical therapy, flared up following the administration of Pfizer-BioNTech's COVID-19 vaccine. The second case is a 57-year-old female with a past medical history of hypertension and hypothyroidism controlled. Develop the new onset of lichen planus after receiving the third dose of the COVID 19 vaccine. The lesions arise 3 weeks after the third dose.

17.
Vaccines (Basel) ; 10(3)2022 Mar 20.
Article in English | MEDLINE | ID: covidwho-1818229

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.

18.
Biochemical and Cellular Archives ; 21(2):1-2, 2021.
Article in English | EMBASE | ID: covidwho-1812557
19.
Cureus ; 14(2): e22669, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1761162

ABSTRACT

Lichen planus is an autoimmune inflammatory disease that can be associated with infections, drugs, and vaccines. Recently, it has been reported to occur following mRNA-based COVID-19 vaccines, particularly the Pfizer/BioNTech vaccine. We present the first reported case of lichen planus that developed after five days following the administration of the first dose of the Oxford-AstraZeneca vaccine in a 46-year-old healthy male. The skin eruption was purple, ill-defined, non-scaly, itchy, and distributed over his face, abdomen, back, and legs. The clinical appearance of the skin eruption and histopathology confirmed the diagnosis of lichen planus. The skin lesions were not responding well to topical steroid and oral antihistamine treatment. Thus, the patient was commenced on systemic hydroxychloroquine. The mechanism of lichen planus development following the administration of COVID-19 vaccines is unclear and needs more investigations and explanations. Healthcare providers should be aware of this possible adverse reaction following the administration of different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. The histopathological features of lichen planus in our case are different from those found in the lichenoid drug eruption. This finding indicates different pathophysiology that needs further investigation.

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