Lichen planus following HBV vaccination: a coincidence?

Ciaccio, Marina; Rebora, Alfredo

doi:10.1111/j.1365-2133.1990.tb08294.x

Cited by 41 publications

(37 citation statements)

References 5 publications

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“…We are aware of 18 cases [2, 3, 4, 5, 6, 7, 8, 9, 10, 11], including 2 observed by us and still unpublished (table 1). What could have been a coincidence in 1990 [2], should be now recognized as a genuine side effect of the HBV vaccine [12]. …”

Section: Introductionmentioning

confidence: 99%

“…In the other cases, the titers ranged between 82 [8]and 582 IU/l [7]. In 2 cases [2]and one of our cases], also HBcAb was present, an antibody that cannot be induced by the vaccines. Because of the negative prevaccination serology, this was probably a false-positive finding.…”

Section: Introductionmentioning

confidence: 99%

“…In the original case [2], the HBsAb titer was low (16 IU/l) and even disappeared 1 year later. In the other cases, the titers ranged between 82 [8]and 582 IU/l [7].…”

Section: Introductionmentioning

confidence: 99%

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Lichen planus as a Side Effect of HBV Vaccination

et al. 1999

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lichen planus as a Side Effect of HBV Vaccination

et al. 1999

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“…Since the reaction has occurred following vaccination with all types of HBV vaccines and given the diversity of these vaccines, it seems plausible that any factor common in all vaccines is a candidate causal factor. The only common constituent is the protein S fraction of the HBsAg [3, 5, 9, 10, 11, 12, 13, 14]. Based on the clinical and histological features and the time course of the postvaccine LP, it has been speculated that a T-cell-mediated, graft-versus-host-like reaction takes place.…”

Section: Discussionmentioning

confidence: 99%

“…In 1990, Ciaccio and Rebora [9]described the first case of LP following vaccination against HBV. Since then, less than 20 cases of LP or lichenoid reactions following HBV vaccination with all types of vaccines (recombinant and plasma-derived) have been reported [3, 5, 10, 11, 12, 13, 14].…”

Section: Discussionmentioning

confidence: 99%

Papulonodular Lichenoid and Pseudolymphomatous Reaction at the Injection Site of Hepatitis B Virus Vaccination

et al. 2002

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Immunization with the hepatitis B virus (HBV) is effective and safe with an estimated incidence of adverse reactions, either local or systemic, of less than 0.1%. Cutaneous side effects are rare and include lichen planus (LP) and lichenoid reactions. We report the case of a 21-year-old female, in whom a persistent, papulonodular lesion developed at the site of the injection, 6 weeks after the second dose of the HBV. Histological examination revealed lichenoid and pseudolymphomatous features. In addition, sensitization to thiomersal, a vaccine constituent, was documented by patch testing. The association of LP with chronic liver disease is well established. Furthermore, less than 20 cases of lichen or lichenoid reactions, following HBV vaccination, have been reported. Although several arguments have been presented, it is still debated whether there is a causal association or the occurrence of LP following HBV vaccination is a simple coincidence. It has been speculated that a T-cell-mediated, graft-versus-host-like reaction, triggered by a sensitizing protein, is directed against keratinocytes expressing an epitope of hepatitis B surface antigen or a similar epitope. Our case may represent a localized lichenoid reaction to HBV vaccination, a local reactive hyperplasia or a persisting delayed hypersensitivity reaction to a vaccine constituent. This is the first case of a local lichenoid reaction at the injection site of the HBV vaccine, providing further documentation for a causal association linking the HBV vaccine with LP.

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