COVID-19 and Oral Lichen Planus: Between an "Intriguing Plot" and the "Fata Morgana Effect"

Area of Science:

• Immunology
• Dermatology
• Infectious Diseases

Background:

• The COVID-19 pandemic has presented with diverse clinical manifestations beyond respiratory symptoms.
• Oral lichen planus (OLP) is a chronic inflammatory condition linked to immune dysregulation and various triggers.
• SARS-CoV-2 infection and pandemic-related stress are potential new factors influencing OLP.

Purpose of the Study:

• To explore the potential association between COVID-19 (SARS-CoV-2) and the onset or exacerbation of oral lichen planus (OLP).
• To investigate the role of SARS-CoV-2 spike protein and psychological stress in OLP pathogenesis.
• To highlight the diagnostic challenges and need for further research into the COVID-19-OLP connection.

Main Methods:

• Review of clinical observations linking COVID-19 to OLP.
• Discussion of the immunological mechanisms involving SARS-CoV-2 spike protein and TRIM21 in OLP.
• Consideration of psychological stress as a contributing factor.

Main Results:

• SARS-CoV-2 spike protein exposure may induce autoimmune reactions triggering OLP.
• Overexpression of TRIM21 in OLP lesions and COVID-19 patients suggests a potential immunological link.
• Psychological stress from lockdowns/quarantine may exacerbate OLP.

Conclusions:

• COVID-19 infection and pandemic-related stress are potential triggers for oral lichen planus.
• The E3 ligase TRIM21 may play a role in the interplay between COVID-19 and OLP.
• Further investigation is crucial to elucidate the complex relationship between COVID-19 and OLP, aiding diagnosis and treatment.