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 v...

Full description

Saved in:
Bibliographic Details
Published in:Vaccines (Basel) 2023-02, Vol.11 (2), p.438
Main Authors: Sapadin, Yonatan K, Mermelstein, Elazar, Phelps, Robert G, Basler, Christopher F, Tufariello, JoAnn M, Lebwohl, Mark G
Format: Article
Language:English
Subjects:
Adverse and side effects
Case reports
Coronaviruses
COVID-19
COVID-19 vaccines
Cytokines
Cytotoxicity
Dermatitis
Development and progression
Diagnosis
Drugs
Hyperpigmentation
Inflammation
Lichen planus
lichenoid eruption
lichenoid reaction
Literature reviews
Lymphocytes
Lymphocytes T
mRNA
Pathology
Risk factors
Severe acute respiratory syndrome coronavirus 2
Skin diseases
Skin eruptions
vaccination
vaccine
Vaccines
Viral diseases
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:2076-393X
2076-393X
DOI:10.3390/vaccines11020438