Lichen planus flare following COVID‐19 vaccination: A case report

• Published in: Clinical case reports Vol. 9; no. 12; pp. e05092 - n/a
• Main Authors: Herzum, Astrid, Burlando, Martina, Molle, Mattia F., Micalizzi, Claudia, Cozzani, Emanuele, Parodi, Aurora
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-12-2021; John Wiley and Sons Inc; Wiley
• Subjects: Authorship; Case Report; Case reports; Conflicts of interest; Consent; Coronaviruses; COVID-19 vaccines; COVID‐19 cutaneous; COVID‐19 vaccination; COVID‐19 vaccine; COVID‐19 skin; Cytokines; lichen planus; Pathogenesis; Severe acute respiratory syndrome coronavirus 2; Steroids; Viral infections; COVID‐19 skin; COVID‐19 vaccine; COVID‐19 cutaneous; lichen planus; COVID‐19 vaccination
• ISSN: 2050-0904; 2050-0904
• DOI: 10.1002/ccr3.5092

We report the third case of cutaneous lichen planus (LP) following COVID‐19 BNT162b2 vaccination in a 59‐year‐old woman with previous LP. The reactivation of LP in patients with dormant LP suggests a possible vaccine‐induced immune dysregulation. We suggest that the already described vaccine‐induced upregulation of Th1 response may play a relevant role in LP reactivation, through an increase in inflammatory cytokines involved in the pathogenesis of LP. Interestingly, LP has already been associated with vaccinations and viral infections including COVID‐19 disease. However, the exact mechanism underlying LP (re)activation after Pfizer‐BiotNtech COVID‐19 vaccination is still widely unknown and needs to be further investigated.
BNT162b2 COVID‐19 vaccine induces upregulation of Th1 response, which increases the levels of IL‐2, IFN‐γ, and TNFα, possibly inducing an immune dysregulation that may reactivate autoimmune diseases such as lichen planus.