Lichen Planus May Be Linked to COVID-19 Infection and Vaccination

Both COVID-19 infection and vaccination may be correlated with the development of lichen planus.

COVID-19 infection and vaccination may be associated with the development of lichen planus (LP), researchers reported in study findings published in the Journal of the European Academy of Dermatology and Venereology.

Investigators conducted a systematic review of LP reports after COVID-19 infection and vaccination. They searched PubMed and MEDLINE for relevant articles published from December 12, 2019, through May 31, 2022.

The Preferred Reporting Items for Systematic and Meta-Analysis guidelines were used for screening and reviewing the articles.

A total of 25 articles with 26 patients (mean age, 55.3 years; 65.4% female) who had LP after COVID-19 infection or vaccination were included.

We believe that benefits of COVID-19 vaccination significantly outweigh potential risks, particularly because LP is rare and can be treated.

A majority (84.6%) of LP diagnoses occurred after COVID-19 vaccination vs after COVID-19 infection (15.4%). Most patients (80.8%) were newly diagnosed with LP, compared with having an exacerbation or recurrence of preexisting disease (19.2%).

There were 4 patients who experienced new-onset LP after COVID-19 infection. Also, 5 patients who had an exacerbation or recurrence of LP had received the COVID-19 vaccination. LP symptoms developed an average of 13.4 days after COVID-19 infection or vaccination.

Study limitations include reporting bias, and the researchers believe it is “unlikely that vaccine components pose significant additional risks to patients.”

“Given the small number of affected patients in our review, we hesitate to draw further conclusions from our data,” stated the study authors. “We believe that benefits of COVID-19 vaccination significantly outweigh potential risks, particularly because LP is rare and can be treated. Where reported, some patients in our study had partial or full resolution after 4 weeks of treatment. As it would be unusual for LP to improve after 4 weeks, some cases reported as LP may have been lichenoid reactions to COVID-19 infection or vaccination.”

References:

Nguyen B, Perez AG, Elgart GW, Elman SA. Lichen planus after COVID-19 infection and vaccination: a systematic review. J Eur Acad Dermatol Venereol. Published online November 17, 2022. doi:10.1111/jdv.18752