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Lichen Planus Following COVID-19 Infection and Vaccination. Matched Case-Control Study.

Paolo Giacomo Arduino1, Alexey Kubanov2, Anna Vlasova3

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The Australasian Journal of Dermatology
|May 5, 2025
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Summary

COVID-19 infection and vaccination are strongly associated with new-onset lichen planus (LP). This suggests that COVID-19 related events, particularly infection, may trigger LP development.

Keywords:
COVID‐19SARS‐CoV‐2infectionslichen planusvaccination

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Area of Science:

  • Dermatology
  • Epidemiology
  • Infectious Diseases

Background:

  • Reports indicate new-onset lichen planus (LP) following COVID-19 infection or vaccination.
  • Case series are insufficient for exposure-outcome association studies.

Purpose of the Study:

  • To investigate the association between COVID-19 related events and de novo lichen planus (LP).

Main Methods:

  • Matched case-control study design.
  • Inclusion of histologically confirmed, newly diagnosed LP patients and matched controls.
  • Exclusion of cases/controls with known LP triggers.
  • Assessment of COVID-19 infection (PCR-confirmed) and vaccination (viral vector) within one month prior to diagnosis.
  • Analysis using conditional and unconditional logistic regression.

Main Results:

  • Fifty-five case-control pairs were analyzed.
  • Significant association found between COVID-19 related events and LP (OR 7.50, 95% CI 1.72-32.80; OR 4.45, 95% CI 1.63-12.15).
  • Subgroup analysis confirmed association with symptomatic COVID-19 infection.

Conclusions:

  • A strong significant association exists between COVID-19 infection/vaccination and de novo LP.
  • COVID-19 related events, especially infection, may act as triggers for lichen planus.