A pruritic psoriatic plaque develops at the donor site of an autologous skin graft: Koebner phenomenon

The patient said that the lesions had developed gradually over the previous few weeks. 3 months earlier, he had developed necrotising fasciitis of his right forearm after a fishing trip; tissue cultures had grown Vibrio vulnificus and an emergency fasciotomy had been done by plastic surgery colleagu...

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Bibliographic Details
Published in:The Lancet (British edition) 2021-11, Vol.398 (10313), p.1836-1836
Main Authors: Murphy, Michael J, Damsky, William, Vesely, Matthew D
Format: Article
Language:English
Subjects:
Anti-Inflammatory Agents - therapeutic use
Autografts
Betamethasone - therapeutic use
Biopsy
Emergency response
Fasciitis
Forearm
Humans
Immune system
Inflammation
Lesions
Male
Middle Aged
Necrotizing fasciitis
Plastic surgery
Psoriasis
Psoriasis - etiology
Psoriasis - pathology
Radiation
Skin & tissue grafts
Skin diseases
Skin grafts
Skin lesions
Skin Transplantation - adverse effects
Transplant Donor Site - pathology
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Summary:The patient said that the lesions had developed gradually over the previous few weeks. 3 months earlier, he had developed necrotising fasciitis of his right forearm after a fishing trip; tissue cultures had grown Vibrio vulnificus and an emergency fasciotomy had been done by plastic surgery colleagues. The isomorphic response—often referred to as the Koebner phenomenon—is characterised by the appearance of a typical skin lesion of an existing dermatosis at sites of cutaneous injury; cellular injury releasing inflammatory mediators followed by immune cell recruitment is thought to be involved. The clinical and histological features of the lesion are usually identical to that of the underlying dermatosis, and it should be treated in the same manner (video).
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(21)02332-1