The koebner phenomenon is defined as the appearance of cutaneous lesions on previously noninvolved. Reverse koebner phenomenon in leukocytoclastic vasculitis. The koebner phenomenon the koebner phenomenon miller, robert a. Koebner phenomenon induced by failed revisional orthopedic s. The koebner phenomenon is a reaction to skin injury often seen in psoriasis patients, and victims of some other diseases. Objectives skin and joint involvement in psoriasis pso and psoriatic arthritis psa are thought to relate to the socalled koebner response. It is also known as the reverse koebner phenomenon. The koebner phenomenon first described in 1877 106 is the capacity of reproducing skin lesions at the sites of local injury. The development of vitiligo at the site of physical injury such as cuts, abrasions, or surgical wounds is referred to as isomorphic koebner phenomenon ikp. Koebner phenomenon leena alahmari, md,a rawan almesned, md,a ahmed alhumidi, md,b and abdullah alkhalifah, mdc riyadh, saudi arabia key words. In the field of dermatology, the renbok phenomenon is a phenomenon where one skin condition inhibits another.
Koebners phenomenon synonyms, koebners phenomenon pronunciation, koebners phenomenon translation, english dictionary definition of koebners phenomenon. Heinrich koebner and his phenomenon dermatology jama. The koebner phenomenon is not unique to diseases reported in the literature. Heinrich koebner 18381904, one of the outstanding dermatologists of the 19th century, is not only well known as the person who first described the koebner phenomenon in psoriasis, but also as a founder of the university dermatology clinic and pioneer of dermatology in breslau. Dec 20, 2019 koebner phenomenon refers to the appearance of new psoriatic lesions in nonpsoriatic skin regions following an injury to that healthy area of skin 1,2,3. Chronic pressure leading to both epidermal and dermal injury is known to elicit koebner response. Koebners phenomenon article about koebners phenomenon by. This page was last edited on 2 october 2019, at 09. He studied medicine 18551859 in breslau and berlin. Pdf on may 1, 2004, devinder mohan thappa and others published the isomorphic phenomenon of koebner find, read and cite all the research you need on researchgate. Koebner phenomenon refers to the appearance of new psoriatic lesions in nonpsoriatic skin regions following an injury to that healthy area of skin 1,2,3. Several other skin diseases, such as lichen planus, vitiligo and darier disease, can present with koebner phenomenon. The koebner phenomenon parapsoriasis rash for some people with psoriasis, even the tiniest pinprick or a bite from a mosquito can trigger plaques to appear in new places. Lichen planopilaris llp is a rare, progressive disease of the scalp and is an important cause of scarring alopecia.
Six months before, she had presented typical lesions of dermatomyositis. In rare instances, koebner phenomenon of psoriasis may occur at the site of healing or healed shingles. A bland ointment may be inhibitory but topical corticosteroids have not been shown to prevent koebner phenomenon. The koebner phenomenon, international journal of dermatology. Vaccinations, sunburns and scratches can all trigger a koebner response. Koebner phenomenon refers to the emergence of new psoriatic lesions in the healthy skin regions following an injurytrauma to psoriatic patients. Koebners phenomenon kp has been observed in a number of skin diseases, including vitiligo. The koebner phenomenon was first described by heinrich koebner 18381904, one of the outstanding dermatologists of the 19th century. Lichen planopilaris with koebner phenomenon jaad case reports.
The koebner phenomenon kp was first described in 1876 by heinrich koebner, a german dermatologist who was the founder of the dermatology department at the university of breslau. Heinrich koebner, md, first described the isomorphic phenomenon. An occurrence, circumstance, or fact that is perceptible by the senses. The occurrence of psoriatic lesions at unusual areas of the body regions such as on penis, around eyes and on keloids suggests that the koebner phenomenon may be responsible. Concise report deep koebner phenomenon of the flexor tendonassociated accessory pulleys as a novel factor in tenosynovitis and dactylitis in psoriatic arthritis.
Introduction lichen planopilaris llp is a rare, progressive disease of the scalp and is an important cause of scarring alopecia. Developing shinglesinduced koebner phenomenon in a. He reported the formation of psoriasiform lesions in uninvolved skin of psoriatic patients after cutaneous trauma, such as excoriations, tattoos, and horse bites. Pdf induction of psoriasis and koebners phenomenon. It describes the formation of psoriatic skin lesions on parts of the body that arent. Surgical interventions are still considered useful only when lesions become refractory to medical. Koebnerization can be induced by various modes of trauma. Psoriasis can appear in areas of the skin that have been injured or traumatized. The exact mechanism of the koebner phenomenon is not known. Cutaneous diseases reported to show a pseudo koebner phenomenon and the corresponding mechanism of trauma are also detailed. Although best known in psoriasis, the koebner phenomenon also occurs in other skin diseases, notably lichen planus, lichen nitidus and dariers disease. The koebner phenomenon describes the appearance of new skin lesions on areas of cutaneous injury in otherwise healthy skin.
Koebners phenomenon definition of koebners phenomenon by. We present a case of henochschonlein purpura in an adult female manifesting with a vasculitic rash with koebner phenomenon. The tendency for skin lesions to appear on lines of trauma. Koebner phenomenon leading to formation of new psoriatic. Henochschonlein purpura is a systemic type of leukocytoclastic vasculitis, characterized by immunoglobulin amediated blood vessel injury. The histological findings were consistent with psoriasis vulgaris c. Koebner phenomenon definition of koebner phenomenon by.
Koebner phenomenon is most likely to lead to which of the following skin. The isomorphic response later called the kp was first described by german dermatologist, heinrich koebner, in 1876. Isomorphic reaction the appearance of new lesions of a skin diseasein particular psoriasis, but also lichen planus or eczema at a site of trauma. The koebner phenomenon may result from either a linear exposure or irritation. Surgical interventions are still considered useful only when lesions become refractory to. The koebner isomorphic phenomenon response is probably one of the most well known. The koebner phenomenon can be treated if it is caught early enough. A listing of skin conditions exhibiting the koebner and. An allornone principle was shown with the koebner phenomenon. Koebner phenomenon archives psoriasis eczema clinic.
Koebner phenomenon induced by failed revisional orthopedic. The koebner phenomenon has been studied most extensively in. What is the koebner phenomenon the koebner phenomenon describes the appearance of new skin lesions on areas of cutaneous injury in otherwise healthy skin. Koebner phenomenon leading to the formation of new psoriatic. Topical therapy, in the form of coal tar combined with sun exposure, resulted in resolution of psoriasis, though the keloids persisted. Cutaneous diseases reported to show a pseudokoebner phenomenon and the corresponding mechanism of trauma are also detailed.
Skin conditions that exhibit the koebner phenomenon letters. Koebners phenomenon definition of koebners phenomenon. Summary koebners phenomenon kp has been observed in a number of skin diseases. Deep koebner phenomenon of the flexor tendonassociated. Active systemic treatment of psoriasis may suppress the koebner phenomenon. Many faces of koebner phenomenon in psoriasis somesh gupta. High dose statins and fibrates in combination may be. Aug 15, 2005 other skin conditions that exhibit the koebner phenomenon are. Koebner phenomenon kp refers to the appearance of isomorphic pathologic skin lesions on the uninvolved skin as a consequence of traumatic insults in patients who have cutaneous diseases. Both shingles and psoriasis are common cutaneous diseases. Koebner phenomenon refers to the emergence of new psoriatic lesions in the. The presence of psoriatic lesions in those body areas, which are not usually affected by psoriasis suggest the key role of koebner phenomenon in spreading psoriasis,14,31. Six months before, she had presented typical lesions of dermatomyositis including. We have compiled, for the first time in the dermatologic literature, an extensive list of the cutaneous diseases reported to demonstrate koebnerization, correlated in each case with the precise source of trauma.
The koebner phenomenon kp, first described in 1876 by heinrich. Skin conditions that exhibit the koebner phenomenon. This could be the possible explanation of koebner phenomenon in psoriasis occurring at the site of healing herpes zoster lesions. Eruptive xanthomas with koebner phenomenon, type 1. Koebner phenomenon has rarely been reported in patients with dermatomyositis, in one case from steam burn1 and in another, a possible scratch2. Files are available under licenses specified on their description page. This isomorphic phenomenon is now known to involve numerous diseases, among them vitiligo, lichen planus, and darier disease. Other phenomena in relation to trauma or skin damage are distinct from the koebner phenomenon. Neuraxial opioids are widely used in clinical practice. Senior resident, professor, department of anaesthesia and intensive care, postgraduate institute of medical education and research.
Trauma or surgical incision might cause koebner phenomenon kp in patients with cutaneous diseases, but seldom studies reported. Developing shinglesinduced koebner phenomenon in a patient. Koebner phenomenon in dermatomyositis after subcutaneous. Synonyms for koebners phenomenon in free thesaurus. Herein we describe a case of vitiligo developing koebnerization and dissemination following radiotherapy for esophageal carcinoma. The isomorphic phenomenon of koebner devinder mohan thappa. An interesting and unique image of eruptive xanthomas is presented. The koebner phenomenon is the development of isomorphic pathologic lesions in the. Nikolsky sign and koebner phenomenon free download as powerpoint presentation.
Lichen planopilaris with koebner phenomenon jaad case. If a patient responded to 1 type of stimulus, he or she would react to all. Koebner phenomenon leading to the formation of new. Several cutaneous diseases are related with kp, and psoriasis is the most common. He reported the formation of psoriasiform lesions in uninvolved skin of psoriatic patients. Oct 01, 2019 koebner phenomenon has rarely been reported in patients with dermatomyositis, in one case from steam burn1 and in another, a possible scratch2. Wolfs isotopic response is the emergence of new lesions in the exact place of previous, healed, lesions and is not necessarily due to trauma. Certain medications are associated with triggering psoriasis. Treatment for the cutaneous lesions arising from the koebner phenomenon depends on the associated skin condition. He was a german dermatologist born in 1838 in breslau. The koebner phenomenon is an aspect of psoriasis thats wellknown but not completely understood. Koebnerization and generalized spread of vitiligo following.
Mar 26, 2018 the koebner phenomenon is an aspect of psoriasis thats wellknown but not completely understood. His initial observations and studies resulted from having seen patients who had developed psoriasis at sites of excoriations, horse bites, and tattoos and he first published his findings in 1876. In the philosophy of aristotle aristotle, 384322 b. Psoriasis vulgaris, koebner phenomenon occurs when psoriasis spreads into an area of trauma, seen here with welldelineated erythematous plaque with a silverywhite scale characteristic of psoriasis. We report a 30yearold man with 7month history of scalp psoriasis who developed kp at the areas of developing shingles. The reverse koebner response is seen when an area of vitiligo or psoriasis clears following injury abrasion, cuts. About 25% of the psoriatic patients develop koebner phenomenon kp after various injuries, and in rare instance, kp may occur at the site of healed or healing shingles. All structured data from the file and property namespaces is available under the creative commons cc0 license. Koebners phenomenon synonyms, koebners phenomenon antonyms. Its clinical significance in vitiligo with respect to disease activity and course is still debatable, while its relevance for surgical techniques has been demonstrated in some reports. Koebner phenomenon an overview sciencedirect topics.
The exact etiopathogenesis of koebner phenomenon and reverse koebner phenomenon are poorly understood. Some cases are cured by the cessation of smoking alone. Mycosis fungoides mf is the most frequent type of primary cutaneous tcellnkcell lymphoma. Koebners phenomenon article about koebners phenomenon. Viricella, koebner phenomenon, and psoriasis viricella, koebner phenomenon, and psoriasis veraldi, stefano. The sparing of the involvement of a cutaneous disease in a site that has been previously subjected to a skin disease, congenital nevus or physical insult has been reported in literature by various names, including the inverse koebner phenomenon. Pdf the isomorphic phenomenon of koebner researchgate. Definition the koebner phenomenon kp refers to the appearance of isomorphic lesions following local trauma in skin areas that are not involved with the skin disease. Plasma 1l6 and serum amyloid protein a level during the combination plasmapheresis and chemotherapy. A 71yearold woman sought medical advice for 3 erythematous patches on her thighs that had developed after subcutaneous methotrexate injections figures 1a and 1b. In conclusion, the first case is the first report of an association of keloids and psoriasis, i. Koebner phenomenon kp plays a very important role in the pathogenesis of vitiligo, with varying physical and chemical trigger factors. Other skin conditions that exhibit the koebner phenomenon are. Conditions demonstrating linear lesions after a linear exposure to a.
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