Koebner Phenomenon

Koebner Phenomenon

[This phenomenon is also termed the isomorphic response]

Appearance of new skin lesions on previously unaffected skin secondary to trauma.
Koebner phenomenon seen in –

  1. Psoriasis,
  2. Vitiligo,
  3. Lichen planus

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Koebnerization – function as a clinical indicator of disease activity in vitiligo, as well as serve as a predictor of treatment response

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Other conditions have demonstrated the Koebner phenomenon

  1. leukocytoclastic vasculitis
  2. mycosis fungoides
  3. eruptive xanthomas

Classification and Subtypes of the Koebner Phenomenon

Boyd and Nelder classified

First group [category I] referred to as true koebnerization,

  1. psoriasis,
  2. lichen planus,
  3. vitiligo.

Koebner phenomenon is reproducible in all patients by a variety of insults.

Boyd and Nelder argued that the term Koebner phenomenon should be typically reserved for this group of diseases.

Second group [category II] –pseudo-koebnerization,

  1. molluscum contagiosum
  2. verruca vulgaris

whereby the Koebner phenomenon gets produced by the seeding of infectious agents along with sites subjected to trauma, usually from scratching.

Third group [category IIII],  occasional lesions,

  1. Darier disease
  2. Erythema multiforme,

which meet some criteria for the Koebner phenomenon but not all.

Fourth group [category IV] – questionable trauma-induced process, includes all disorders with a dubious association with trauma, such as pemphigus vulgaris and lupus erythematosus.

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