key: cord-1022756-7ilqwnxp authors: Zengarini, Corrado; Piraccini, Bianca Maria; La Placa, Michelangelo title: Lichen Ruber Planus occurring after SARS‐CoV‐2 vaccination date: 2022-02-26 journal: Dermatol Ther DOI: 10.1111/dth.15389 sha: 7e53d10cde04c927fad23c114bb509022a8817ef doc_id: 1022756 cord_uid: 7ilqwnxp nan He did not report any additional symptoms. The past medical history is silent, and he has not taken drugs in chronic nor in a discontinuous manner in the last year. When examined, the patient presented erythematous papules on the upper and lower limbs, while on the feet formed small plaques with a keratotic centre. No other lesions were found on oral and genital mucosa ( Figure 1A The onset of LP after vaccination in our patient may have multiple pathogenetic mechanisms. Among these, we believe that T-cells play an essential role in the immune response against the cells of the basal layer of the skin in predisposed patients due to the increase in circulating pro-inflammatory cytokines induced by the vaccine response. 8 Another mechanism may be reconducted to ACE-2 receptors in the skin. 9 Spike proteins generated by the vaccine may link to the cutaneous cells presenting this receptor and start an immune response by recruiting CD4+ lymphocytes, eventually causing LP in predisposed subjects. While considering that any inflammatory stimulus, such as vaccinations, can act as a potential trigger of autoimmune disease, such LP in predisposed subjects, data currently do not contraindicate future Anti-Sars-Cov2 vaccinations of any type in this kind of patients. We conclude with a reminder for dermatologists and practitioners to continue investigating any onset of clinical signs F I G U R E 1 (A) detail of the Lichen of the right foot; (B) Papules of the right arm; (C) Whickam striae, characteristics of lichen planus, observed at Dermoscopy Assessment of pruritus intensity: prospective study on validity and reliability of the visual analogue scale, numerical rating scale and verbal rating scale in 471 patients with chronic pruritus Lichen planus arising after COVID-19 vaccination Annular lichen planus associated with coronavirus SARS-CoV-2 disease (COVID-19) Koebner phenomenon with lichen planus in an area of previous vitiligo after COVID-19 vaccination and the creation of a locus minoris resistentiae. J Eur Acad Dermatol Venereol National Institute of Diabetes and Digestive and Kidney Diseases Psoriasis flare-up associated with second dose of Pfizer-BioNTech BNT16B2b2 COVID-19 mRNA vaccine The attentive focus on T cell-mediated autoimmune pathogenesis of psoriasis, lichen planus and vitiligo The inflammation in cutaneous lichen planus is dominated by IFN-Υ and IL-21-a basis for therapeutic JAK1 inhibition High expression of ACE2 on keratinocytes reveals skin as a potential target for SARS-CoV-2