Lichen Planus Occurring after Influenza Vaccination: Report of Three Cases and Review of the Literature

Abstract

Although influenza vaccine is thought to be effective and safe, it occasionally causes systemic reactions such as toxic epidermal necrolysis, bullous pemphigoid, lichen planus (LP), etc. The period of increased risk of developing these events was different depending on the immune responses induced by the vaccination. We report 3 cases of LP which appeared after an influenza vaccination. Our cases indicate that the period of increased risk of developing vaccine-related LP was concentrated within 2 weeks after vaccination, and that the vaccine alone represents a triggering factor necessary for immune alteration sufficient for the development of LP. Because these adverse events tend to develop over a predictable time course, the time of onset may give an important clue to the diagnosis of vaccine-related diseases. We suggest that a history of recent vaccination should be sought in all patients presenting with linear LP.

Cytophagic Histiocytic Panniculitis after H1N1 Vaccination: A Case Report and Review of the Cutaneous Side Effects of Influenza Vaccines

“…CHP may be associated with viral infections, malignancies and autoimmune disorders [4,5]. In CHP, the neoplastic or reactive T cells, mainly Th1, are responsible for abnormal pro-inflammatory cytokine secretion such as γ-interferon and tumour necrosis factor α [23].…”

“…In the literature there are 19 papers reporting 37 patients experiencing skin adverse effects after an influenza vaccination [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22]. There are only 2 reports of a typical drug reaction after an influenza vaccination: a case of generalized bullous fixed drug eruption and a case of toxic epidermal necrolysis [6,13].…”

“…There are only 2 reports of a typical drug reaction after an influenza vaccination: a case of generalized bullous fixed drug eruption and a case of toxic epidermal necrolysis [6,13]. Other papers report neutrophilic dermatosis, bullous pemphigoid, pemphigus, vasculitis, Gianotti-Crosti syndrome, dermatomyositis and lichen planus (table 1) [4,5,7,8,9,10,11,12,14,15,16,17,18,19,20,21,22]. Tsushima et al [14] reported a case of an erythema-nodosum-like eruption appearing 7 days after an influenza vaccination.…”

“…In France by June 1, 2010, 5.36 million people had received the H1N1 vaccine [3]. This vaccine was supposed to be safe [4]. Cutaneous adverse effects consisting mainly of a local reaction with erythema, induration and pain at the vaccination site are rarely reported [4,5].…”

“…This vaccine was supposed to be safe [4]. Cutaneous adverse effects consisting mainly of a local reaction with erythema, induration and pain at the vaccination site are rarely reported [4,5]. Rare cases of systemic reactions with cutaneous manifestations such as vasculitis or neutrophilic dermatosis have been observed [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22].…”