Arduino Paolo Giacomo, Kubanov Alexey, Vlasova Anna, Martynov Andrey, Petti Stefano
Department of Surgical Science, University of Turin, Turin, Italy.
State Research Center of Dermato-Venereology and Cosmetology, Moscow, Russian Federation.
Australas J Dermatol. 2025 Aug;66(5):289-295. doi: 10.1111/ajd.14522. Epub 2025 May 5.
New-onset lichen planus (LP) development following COVID-19 infection/vaccination is reported. Since case series cannot be used to study exposure-outcome associations, we designed this matched case-control study to investigate whether COVID-19-related events and de novo LP are associated.
Patients with histologically confirmed LP, newly diagnosed at the National Research Center of Dermato-Venereology of Moscow (September 2020-December 2022), were considered. Sex/age/ethnicity-matched controls attending the same Center in the same period for consultations on conditions unrelated to LP were selected. Cases/controls with known LP trigger factors were excluded. COVID-19-related events were: symptomatic COVID-19 (PCR-confirmed), and COVID-19 vaccination (viral vector vaccine) occurred ≤ 1 month before the visit at the Center. The association between COVID-19-related events and LP was assessed with conditional (Mantel-Haenszel method) and unconditional (logistic regression analysis adjusted for sex, age, and smoking) analyses. Subgroup analysis, with COVID-19 infection and vaccination treated separately, and sensitivity analysis on another group of patients with suspected LP, not confirmed histologically, were also made.
Fifty-five case-control pairs were considered. Mean age (51 years), sex (56.4% females) and ethnicity (100% whites) distributions were the same in both groups. Conditional and unconditional odds ratios resulted 7.50 (95% Confidence Interval -95CI, 1.72-32.80), 4.45 (95CI, 1.63-12.15), respectively (p < 0.05). Subgroup analysis confirmed the association between symptomatic infection and LP, while sensitivity analysis corroborated the results of the primary analysis.
This observational study, reporting a strong significant association between COVID-19 infection/vaccination and de-novo LP, suggests that COVID-19-related events, especially infection, could act as LP trigger factors.
有报告称在新型冠状病毒肺炎（COVID-19）感染/接种疫苗后出现了新发扁平苔藓（LP）。由于病例系列不能用于研究暴露与结局的关联，我们设计了这项匹配病例对照研究，以调查COVID-19相关事件与新发LP是否有关联。
纳入在莫斯科国家皮肤性病研究中心（2020年9月至2022年12月）新诊断的、经组织学确诊为LP的患者。选取同期在同一中心因与LP无关的疾病进行咨询的性别/年龄/种族匹配的对照。排除有已知LP诱发因素的病例/对照。COVID-19相关事件包括：有症状的COVID-19（PCR确诊），以及在到中心就诊前≤1个月接种的COVID-19疫苗（病毒载体疫苗）。采用条件分析（Mantel-Haenszel法）和无条件分析（对性别、年龄和吸烟进行校正的逻辑回归分析）评估COVID-19相关事件与LP之间的关联。还进行了亚组分析，将COVID-19感染和接种疫苗分别处理，并对另一组疑似LP但未得到组织学确诊的患者进行了敏感性分析。
共纳入55对病例对照。两组的平均年龄（51岁）、性别（56.4%为女性）和种族（100%为白人）分布相同。条件比值比和无条件比值比分别为7.50（95%置信区间-95CI，1.72-32.80）、4.45（95CI，1.63-12.15）（p<0.05）。亚组分析证实了有症状感染与LP之间的关联，而敏感性分析证实了主要分析的结果。
这项观察性研究报告了COVID-19感染/接种疫苗与新发LP之间存在强烈的显著关联，提示COVID-19相关事件，尤其是感染，可能是LP的诱发因素。
