Autoimmune Skin Diseases In The Era Of COVID-19: Pathophysiological Insights And Clinical Implications

September 2025 in “ Microorganisms ”

Aikaterini Ι. Liakou, Eleni Routsi, Kalliopi Plisioti, Eleni Tziona, Dimitra Koumaki, Magdalini Kalamata, Evangelia‐Konstantina Bompou, Rozeta Sokou, Πέτρος Ιωάννου, Stefanos Bonovas, George Samonis, Andreas G. Tsantes, Alexander J. Stratigos

alopecia areata psoriasis hidradenitis suppurativa SARS-CoV-2 molecular mimicry dysregulated immune responses mRNA vaccines autoimmune skin diseases

Studysummary In this review, the authors explore the complex interplay between COVID-19 and autoimmune skin diseases, finding that SARS-CoV-2 may trigger or worsen these conditions, with increased risks following infection and vaccination, particularly with mRNA vaccines.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The document reviews the complex relationship between COVID-19 and autoimmune skin diseases (ASDs), such as alopecia areata, psoriasis, and hidradenitis suppurativa, highlighting that SARS-CoV-2 can trigger or exacerbate these conditions through mechanisms like immune dysregulation and cytokine signaling. Epidemiological data indicate increased incidence and flares of ASDs post-COVID-19 infection and vaccination, with mRNA vaccines posing a higher risk for hidradenitis suppurativa flares. Despite initial concerns, biologic therapies for psoriasis and HS do not appear to increase COVID-19 severity. The review underscores the importance of continued research to understand these interactions and improve patient management, emphasizing individualized vaccination planning and long-term monitoring for patients with autoimmune skin diseases.

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research Could Vaccination Against COVID-19 Trigger Immune-Mediated Inflammatory Diseases?

4 citations , August 2024 in “Journal of Clinical Medicine”

This study reported an increased likelihood of hidradenitis suppurativa flares in patients who received mRNA COVID-19 vaccines compared to those who received non-mRNA vaccines, indicating a potential association that warrants further research in larger populations.

research The Correlation Between Coronavirus Disease 2019 and Alopecia Areata: A Literature Review

7 citations , July 2024 in “Frontiers in Immunology”

This article reviews current research on the link between COVID-19 and alopecia areata, suggesting COVID-19 may increase the risk of autoimmune diseases, including alopecia, especially in those over 40, and discusses potential mechanisms and treatment options.

research Unmet Medical Needs in Chronic, Non-Communicable Inflammatory Skin Diseases

59 citations , June 2022 in “Frontiers in medicine”

This review discusses the complex causes and treatment challenges of chronic inflammatory skin diseases, emphasizing the need for biomarkers to predict treatment responses; it reports no new clinical results.

research Case Report: Rowell Syndrome-Like Flare of Cutaneous Lupus Erythematosus Following COVID-19 Infection

8 citations , February 2022 in “Frontiers in Medicine”

This article reports a case of Rowell syndrome in a woman with chronic cutaneous lupus erythematosus that appeared to be triggered by COVID-19 infection, suggesting a potential connection.

research Teledermatology in the COVID-19 Pandemic: A Systematic Review

40 citations , August 2021 in “JAAD international”

This review found that teledermatology was significantly used during the COVID-19 pandemic, particularly for managing common ambulatory dermatoses like acne and eczema.

research Italian Survey for the Evaluation of the Effects of Coronavirus Disease 2019 Pandemic on Alopecia Areata Recurrence

24 citations , February 2021 in “Dermatology and Therapy”

This study reported a significant relapse in alopecia areata among patients infected with COVID-19, possibly due to the infection's inflammatory response and stress from quarantine.

research What Causes Hidradenitis Suppurativa?—15 Years After

78 citations , October 2020 in “Experimental Dermatology”

This review summarizes 15 years of clinical and experimental research advancements in hidradenitis suppurativa, highlighting its recognition as a uniquely healable inflammatory skin disease but reports no new clinical results.

research Evaluation of the Relationship Between Alopecia Areata and Viral Antigen Exposure

19 citations , August 2017 in “American journal of clinical dermatology”

This analysis reports that hepatitis B surface protein antigen exposure is associated with an increased risk of alopecia areata.

research Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

291 citations , January 2014 in “The Scientific World Journal”

Lichen Planus is a less common condition affecting skin and mucous membranes, with various types and associated risk factors, challenging to diagnose, significantly impacts life quality, and may have a risk of cancerous changes in oral lesions.