Kobnerization

Locus minoris resistentiae (lmr) can be defined as a site of the body that offers lesser resistance than the rest of the body to the onset of disease. The well-known Köbner phenomenon is itself a clear example of lmr in dermatology. The new term locus maioris resistentiae (LMR), a site of the body that offers greater resistance than the rest of the body to the onset of disease, defines the opposite condition. Renbök phenomenon (reverse Köbner's isomorphic response) typically represents an example of LMR.

Necrobiosis lipoidica (NL) is a cutaneous disease entity that typically manifests as atrophic yellow plaques with telangiectasias on the anterior tibial region. Although NL is commonly associated with diabetes mellitus, the role of trauma in disease development is less commonly emphasized. The relationship between NL and the Köbner phenomenon has been established, as a few cases of NL occurring in surgical scars have been reported in the literature. We report the first case of NL occurring in a mastectomy scar on the breast in a non-diabetic female, and explore the relationship between NL, diabetes mellitus, and trauma...

HINTERGRUND UND ZIELE: Unter dem Begriff Pemphigus wird eine Gruppe von Autoimmunkrankheiten zusammengefasst, die durch intraepidermale akantholytische Blasen gekennzeichnet sind. Der isomorphe Reizeffekt, auch als Köbner-Phänomen (KP) bezeichnet, ist definiert als das Auftreten typischer Läsionen einer bestehenden Krankheit nach einem Trauma. Dies wird bei Pemphigus selten beobachtet. Unser Ziel war es, Patienten vorzustellen, die infolge einer Hautverletzung neue Pemphigus-Läsionen entwickelten...

BACKGROUND: The members of Toll-like receptor (TLR) family are responsible for recognizing various molecular patterns associated with pathogens. Their expression is not confined to immune cells and have been detected in skin cells such as keratinocytes and melanocytes. As part of a generated response to pathogens, TLRs are involved in inducing inflammatory mediators to combat these threats. It is therefore not surprising that TLRs have been implicated in inflammatory skin diseases, including atopic dermatitis and psoriasis...

The loss of melanocytes in vitiligo is mainly attributed to defective autoimmune mechanisms and lately autoinflammatory mediators have become more emphasized. Among these, a number of class II cytokines and their receptors have displayed altered expression patterns in vitiligo. Thus, we selected 30 SNPs from the regions of respective genes to be genotyped in Estonian case-control sample (109 and 328 individuals, respectively). For more precise analyses, patients were divided into subgroups based on vitiligo progression activity, age of onset, sex, occurrence of vitiligo among relatives, extent of depigmented areas, appearance of Köbner's phenomenon, existence of halo nevi, occurrence of spontaneous repigmentation, and amount of thyroid peroxidase antibodies...

In June 2014, Annals of Emergency Medicine collaborated with the Academic Life in Emergency Medicine (ALiEM) blog-based Web site to host an online discussion session featuring the Annals Residents' Perspective article "The Opioid Prescription Epidemic and the Role of Emergency Medicine" by Poon and Greenwood-Ericksen. This dialogue included a live videocast with the authors and other experts, a detailed discussion on the ALiEM Web site's comment section, and real-time conversations on Twitter. Engagement was tracked through various Web analytic tools, and themes were identified by content curation...

Annals of Emergency Medicine collaborated with an educational Web site, Academic Life in Emergency Medicine (ALiEM) to host a public discussion featuring the 2014 Annals article on the outpatient management of patients with a spontaneous pneumothorax by using pigtail catheters. The objective was to curate a 14-day (November 10 to 23, 2014) worldwide academic dialogue among clinicians about the article. Four online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and Google Hangout...

In July to August 2014, Annals of Emergency Medicine continued a collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Annals Residents' Perspective article "Integration of Social Media in Emergency Medicine Residency Curriculum" by Scott et al. The objective was to describe a 14-day worldwide clinician dialogue about evidence, opinions, and early relevant innovations revolving around the featured article and made possible by the immediacy of social media technologies...

The etiology of tumor of the follicular infundibulum (TFI) is unknown. Eruptive forms of TFI are rare. We present the case of a 49-year-old woman with multiple lesions on the arms, shoulders, trunk, buttocks, and legs of more than 3 years' duration. On clinical and histologic examination, a diagnosis of multiple TFI was made. Additionally, the patient presented with other rare remarkable features including severe pruritus, the Köbner phenomenon, and underlying inflammatory cell infiltration of the tumors. These findings strongly suggest that eruptive TFI may represent a kind of cutaneous reaction...

A slight epidermal damage can induce the Köbner reaction in psoriasis, and the “alarmin”, interleukin-33 (IL-33), may be involved in this process. Therefore, the uninvolved psoriatic skin was tape-stripped, and skin biopsies were collected at 0 day, 2 h and 3 days or at 0 day, 1 day and 7 days for immunohistochemistry. Eight patients out of 18 with the positive Köbner reaction showed a decrease in epidermal thickness and revealed transient reduction in epidermal nuclear immunostaining of IL-33 in 2-h, 1-day, 3-day biopsies compared to the 10 Köbner-negative patients...

The term isotopic response was coined in 1995(1) to describe the occurrence of a new skin disorder at the site of another, unrelated, and already healed skin disease. That publication paved the way to recognition of this phenomenon by the medical community worldwide with multiple reports describing it under a variety of conditions. The term isotopic response, however, turned out to be unsuitable for a Medline search, because it generated hundreds of references linked with radioactive isotopes. To facilitate Medline searches for this dermatologic phenomenon by avoiding unnecessarily time-consuming sifting through so many unrelated references, it was suggested that the name Wolf be added...

Locus minoris resistentiae (lmr) refers to a body region more vulnerable than others. This ancient concept, which is also present in Achilles' and Siegfried's old epic myths, weaves through many fields of medicine. In any internal organ or external body region with a congenital or acquired altered defense capacity, a disease process may occur more easily than elsewhere. Illustrative instances are the appearance of hepatocarcinoma on a cirrhotic liver, the onset of lung carcinoma in a tuberculosis scar, cases of osteosarcoma arising in chronic osteomyelitis, and carcinoma complicating chronic cholelithiasis, just to name a few...

It is important for dermatologists to be aware of cutaneous changes related to religious practices to help in their recognition and management. The anatomic location of cutaneous lesions associated with friction from praying varies based on religious practice. Allergic contact dermatitis from products and substances commonly used in worshipping also vary by religion. Some religious practices may render individuals prone to infections that manifest on the skin. Tattoos of godly figures also may adorn the body...

Before the arrival of modern pharmacotherapy, drug hypersensitivity reactions were virtually unknown. Toxicity from the many plant-, animal- and inorganic material-derived remedies must have been much more common. One famous example is the intoxications from mercury, which has been used in many ailments, but particularly for the treatment of syphilis. It was only in the 19th century when more and more active principles from e.g. plants were identified, and when the observations of skin reactions became more prevalent...

BACKGROUND: Rosacea is a common dermatosis that can involve the bald area of the scalp. We report the case of a man presenting clinical symptoms of rosacea of the forehead and the scalp, but with a histological picture of familial chronic benign pemphigus. PATIENTS AND METHODS: A 47-year-old man with a history of Hailey-Hailey disease had been presenting facial dermatosis for 5 years. The clinical features were erythema with pustules and scales located on the mid-forehead and the androgenic bald area of the frontal scalp...

Mast cells are involved in the development of psoriatic lesion, but it is not known how mast cells are activated or whether mast cell cytokines are expressed during the lesion development. In this study, the Köbner reaction was induced in uninvolved psoriatic skin of 18 patients using the tape-stripping technique, and a sequence of biopsies was collected at 0 days, 2 h and 3 days or at 0 days, 1 day and 7 days for histochemical analysis. Eight patients developed the Köbner reaction verified at the follow-up visit 2-2·5 weeks later...

Linear skin diseases may follow Blaschko's lines, Langer's relaxed skin tension lines or head zones (dermatomes), thus indicating an embryogenic, hematogenic or neuronal aspect in their pathogenesis. Köbner phenomenon describes the eruption of an inflammatory skin disease following mechanical alteration of the skin. Renbök phenomenon describes an area of non-involvement in an otherwise generalized skin disease. Wolf's isotopic response may be understood as a special subtype of Köbner phenomenon, in which one skin disease triggers a second one...

Autologous epidermal transplantation is an easy, safe, and effective option for the treatment of stable vitiligo. To evaluate the long-term outcome and correlated factors, 1 to 5 years of follow-up of 310 vitiligo patients treated with autologous epidermal transplantation was carried out by questionnaires, telephone calls, and clinical examinations. Some correlated factors including time, gender, age, location, Köbner phenomenon, and exposure to narrowband UVB (NB-UVB) have been considered and analyzed. Twenty-four recipient areas with 1266 sheets were observed and classified with 4 degrees (excellent, good, fair, and poor)...

Multicentric reticulohistiocytosis is a rare systemic disease of unknown aetiology characterized by erosive arthritis and cutaneous lesions consisting of multiple reddish-brown papules and nodules, mainly involving the face and distal upper extremities. It has been suggested that skin eruptions in multicentric reticulohistiocytosis are associated with Köbner phenomenon due to their characteristic distribution, such as on the dorsal aspects of the hands and fingers. We report here a case of a Japanese woman with multicentric reticulohistiocytosis, in whom erythematous macules and papules were widely distributed over the face, ears, neck and the V-area of the chest...

We report an unusual case of disseminated discoid lupus erythematosus (DLE) complicated by pre-existing atopic dermatitis (AD) and late-onset Sjögren's syndrome (SS). Disseminated DLE lesions were sparse on the expected sites for AD, such as the medial region of the extremities or v-neck area. The patient fulfilled the diagnostic criteria for AD and SS but not for systemic lupus erythematosus. Histopathological analysis of the crusted erythematous lesions revealed typical DLE with few FoxP3(+) cells and a moderate number of IL-17(+) cells...