Sex: F
Vaccine: COVID19
Symptoms: Biopsy, COVID-19, Drug ineffective, Investigation, Lichen planus
Clinical narrative: infected with COVID-19 the next month; infected with COVID-19 the next month; vaccine-associated vulvovaginal lichen planus; This is a literature report.  This case report presents a 66-year-old female exhibiting symptoms of vulvovaginal burning, pain, inflammation, and bleeding which were ultimately attributed to lichen planus possibly correlating with the administration of COVID-19 vaccination. Methods: A 66-year-old female with a remote medical history of stage 1 endometrial cancer treated with total hysterectomy and bilateral salpingo-oophorectomy, vulvar herpetic lesions, and psoriasis presented to her dermatologist with a new complaint of "unbearable pain", dyspareunia, vaginal bleeding, irritation, and burning with urination and showering. She used nystatin cream per dermatologist recommendation with minimal relief. After persistence of symptoms for 12 months, in Apr2023, the patient presented to her sexual medicine gynecologist who started her on clobetasol 0.05% ointment for erosive VLP. This was based on a clinical exam and a punch biopsy. Of note, the patient had received multiple doses of the Pfizer COVID-19 vaccine (two vaccines in Feb2021,a booster in Nov2021, and an additional booster in 2022) and symptoms began soon after. Results: Repeat punch biopsies were consistent with a diagnosis of erosive VLP. The patient was subsequently started on six weeks of systemic corticosteroids and pelvic floor therapy and local estrogen therapy. Patient responded well to therapy and no longer reported dyspareunia. She then received her fifth vaccine (Moderna) in Sept2023, was infected with COVID-19 the next month, and experienced a recurrence of VLP shortly after. Patient returned to the gynecologist in Jan2024 and received hydrocortisone vaginal suppositories to help manage the recurrence. By Jun2024, the patient was using tacrolimus and receiving intralesional steroid injections. She is currently feeling better, is sexually active with no issues, and reports minimal pain. Conclusions: This case report highlights the importance of including mucocutaneous complications like VLP on the differential diagnoses if a patient presents similarly after vaccine administration. While there is no current evidence establishing a causal link between COVID-19 vaccination and LP, the timeline of this patient's disease progression and previous case reports of similar instances indicate that the vaccines may potentially serve as a significant triggering factor for the onset or recurrence of this condition. However, the benefits of COVID-19 vaccination greatly outweigh this potential risk, making it a crucial tool for the health and safety of a population.; Sender's Comments: Based on temporal association, there is reasonable possibility of causal association between the Reported events Covid-19, Drug ineffective, Lichen planus  and the suspect drug The impact of this report on the benefit/risk profile of the Pfizer drug is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : US-PFIZER INC-202500160983 Same article/patient/drug and different event;