Oral lichen planus arising after BNT162b2 mRNA COVID-19 vaccine: report of 2 cases.

The ongoing COVID-19 pandemic required a firm and prompt effort in the development of an effective vaccine. Reports of adverse reactions are increasing. Lichen planus, as well as its oral variant, is a condition that has previously been reported to be associated with vaccines. This is one of the first reports of oral lichen planus (OLP) arising after any COVID-19 vaccine. Here the authors present 2 cases of OLP that occurred after BNT162b2 mRNA COVID-19 vaccination (Comirnaty, Pfizer, New York, NY, USA; BioNTech, Mainz, Germany).

Rise and exacerbation of oral lichen planus in the background of SARS-CoV-2 infection.

Oral Lichen Planus (OLP) is a chronic inflammatory disorder whose exact etiology remains unknown. Inflammatory mediators, cytotoxic CD8+ T cells and mast cells have been hypothesized to mediate the pathogenesis of OLP. COVID-19 pandemic caused by SARS-CoV-2 is marked by cytokine storms in the affected patients. Altered T-cell responses marked by exhaustion of T-cell count with hyperaggressive remaining T-cells and presence of cross-reactive antibodies render infected humans as fertile grounds for development of multisystem disorders. In addition, Vitamin D deficiency in COVID-19 patients can further modify the T cell mediated immunity. Increased circulating cytokines and hyperactive CD8+ T cells can alter the oral immune barriers rendering them susceptible to oral disorders. Due to the widespread immune dysregulation, it is possible that patients of COVID-19 may develop OLP in the aftermath or during recovery. The paper explores the pathogenic mechanism behind development OLP as post-COVID condition on account of their target receptor, T-cell responses, cytokine profile, mucosal immune barriers and nutrition deficiency.