Scotto Gaetano, Fazio Vincenzina, Massa Salvatore, Lo Muzio Lorenzo, Spirito Francesca
Infectious Diseases Unit, University Hospital "OORR" Foggia, 71122 Foggia, Italy.
Clinical Chemistry Laboratory, Virology Unit, University Hospital "OORR" Foggia, 71122 Foggia, Italy.
J Clin Med. 2023 Jul 21;12(14):4829. doi: 10.3390/jcm12144829.
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has led to significant morbidity and mortality worldwide since its declaration as a global pandemic in March 2020. Alongside the typical respiratory symptoms, unusual clinical manifestations such as oral lichen planus (OLP) have been observed. OLP is a chronic inflammatory mucocutaneous dermatosis that results from a cell-mediated reaction, and its pathogenesis involves the loss of immunological tolerance. OLP has been associated with several triggering factors, such as certain drugs, stress, smoking, and even some viruses. Exposure to the spike protein antigen of SARS-CoV-2 during an infection can trigger autoimmune reactions and lead to the onset or flare of OLP. The E3 protein ligase TRIM21, which is identified in the lamina propria of OLP lesions, is overexpressed in COVID-19 patients and plays a critical role in autoimmune pathologies. Furthermore, the psychological stress of the lockdown and quarantine can be a trigger for the onset or exacerbation of OLP. However, the diagnosis of OLP is complex and requires a biopsy in order to confirm a clinical diagnosis, rule out other pathologies, and establish the most appropriate therapeutic procedure. Further research is needed to understand the potential link between Co-19 and OLP.
由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019冠状病毒病疫情自2020年3月被宣布为全球大流行以来，已在全球范围内导致了严重的发病和死亡。除了典型的呼吸道症状外，还观察到了如口腔扁平苔藓（OLP）等不寻常的临床表现。OLP是一种由细胞介导的反应引起的慢性炎症性黏膜皮肤病，其发病机制涉及免疫耐受的丧失。OLP与多种触发因素有关，如某些药物、压力、吸烟，甚至一些病毒。感染期间接触SARS-CoV-2的刺突蛋白抗原可引发自身免疫反应，并导致OLP的发作或加重。在OLP病变固有层中发现的E3蛋白连接酶TRIM21在2019冠状病毒病患者中过度表达，并在自身免疫性疾病中起关键作用。此外，封锁和隔离带来的心理压力可能是OLP发作或加重的触发因素。然而，OLP的诊断很复杂，需要进行活检以确认临床诊断、排除其他病变并确定最合适的治疗方法。需要进一步研究以了解2019冠状病毒病与OLP之间的潜在联系。
