Koebner phenomenon

Skin condition where new lesions appear on lines of trauma

Heinrich Köbner, the dermatologist who first described the phenomenon

The Koebner phenomenon, also known as the "isomorphic response," is a reaction in which new skin lesions appear on previously unaffected skin following trauma. This phenomenon is observed in various dermatological conditions, most notably in psoriasis, lichen planus, and vitiligo.

History

The Koebner phenomenon was first described by the German dermatologist Heinrich Köbner in 1872. Köbner observed that patients with psoriasis developed new psoriatic lesions at sites of skin injury, such as scratches or surgical scars. This observation led to the recognition of the Koebner phenomenon as a significant clinical feature in dermatology.

Pathophysiology

The exact mechanism underlying the Koebner phenomenon is not fully understood. However, it is believed to involve a complex interplay of immune system activation, inflammation, and genetic predisposition. In conditions like psoriasis, trauma to the skin may trigger an inflammatory response that leads to the development of new lesions. The role of cytokines and other inflammatory mediators is an area of active research.

Clinical Significance

The Koebner phenomenon is an important diagnostic feature in several skin diseases. Recognizing this phenomenon can aid in the diagnosis of conditions such as:

• Psoriasis: New psoriatic plaques can develop at sites of skin injury.
• Lichen planus: Linear lesions may appear following trauma.
• Vitiligo: Depigmented patches can form in areas of skin damage.

The presence of the Koebner phenomenon can also influence the management and treatment of these conditions, as it highlights the need to minimize skin trauma in affected individuals.

Conditions Associated with the Koebner Phenomenon

The Koebner phenomenon is associated with several dermatological conditions, including but not limited to:

• Psoriasis
• Lichen planus
• Vitiligo
• Lichen sclerosus
• Warts
• Molluscum contagiosum

Management

Management of the Koebner phenomenon involves addressing the underlying skin condition and minimizing skin trauma. Patients are advised to avoid activities that may lead to skin injury, such as scratching or excessive friction. In some cases, topical or systemic treatments may be used to control the underlying disease and reduce the risk of new lesion formation.

Related pages

• Psoriasis
• Lichen planus
• Vitiligo
• Dermatology