A secondary discoid lupus erythematosus induced by scald of edible oil: An illustration of Koebner phenomenon

Abstract

Background Discoid lupus erythematosus (DLE) is a most well‐known clinical variation of chronic cutaneous lupus erythematosus inside the spectrum of lupus erythematosus (LE). Cutaneous trauma remains a significant and peculiar causative factor for DLE. Aims We present a case wherein the patient demonstrated unilateral distribution of DLE on a clinically normal appearing occult facial scald of edible oil, representing Koebner phenomenon (KP) i.e. occurrence of a new skin disease at the site of an unrelated and already healed one. Patient/Methods The 53 years old female patient was unique because she experienced DLE on the nasal back. Results The injury was totally settled following a month treatment of oral hydroxychloroquine and topical 0.03% tacrolimus ointment. After three months, she encountered an accidental edible oil scald on the right upper cheek. Several small vesicles appeared on a soybean‐sized erythema base with a burning sensation. Conclusion We review the literature and conclude by discussing important histologic highlights to think about while endeavoring to perceive the fundamental character and pathogenicity of such sores.

Guideline for the diagnosis, treatment and long-term management of cutaneous lupus erythematosus

“…Koebner phenomenon. Koebner phenomenon has been occasionally reported in patients with CLE following traumas, scratching effects, operation scars, contact dermatitis, pressure from clothing, application of liquid nitrogen, or exposure to strong sun light, infections or heat [36][37][38][39][40].…”

Characteristics and pathogenesis of Koebner phenomenon

“…Physical trauma Trauma [109] Concis [113] Burns [114,115] Freezing [165] Tattoo [116][117][118] UV radiation [102] Facial hair plucking [119] Mechanical stress [57,120] Stretch [15,80,81] Repeated friction or pressure [22] Surgical mask [121,122] Hearing aid [123] Use of computer mouses [124] Keloid/ Hypertrophic scar [3,125,126] Striae distensae [127] Chemical stimulation…”

Diskoid Lupus Eritematozus Hastalarının Klinikoepidemiyolojik Profili ve Sistemik Hastalıklarla İlişkisi

“…Lupus eritematozus (LE) otoimmun hastalıkların bir prototipi olup kutanöz ve sistemik formları bulunmaktadır [1]. Kutanöz LE (KLE) başlığı içinde; akut LE, subakut LE, kronik LE (Diskoid LE, chilblain LE, LE profundus, LE tumidus yer almaktadır [2].…”

“…Diskoid LE (DLE), en sık görülen (50 85%) KLE eritematozus tipidir [1,3]. Daha çok 40-50 yaşları arasında ve kadınlarda daha sık (kadın/erkek oranı:3/1) görülmektedir [4].…”

“…Lezyonlar, bir ya da birden fazla sayıda, keskin sınırlı, eritemli, hiperkeratotik, kolayca ayrışmayan yapışık skuamlı, atrofik skar ya da pigmentasyon bırakarak iyileşen diskoid şekilli yama ya da endure plak şeklinde görülebilir [3,6,7]. DLE lezyonu bulunan hastaların yaklaşık %5-30'u sistemik lupus eritematozusa (SLE) ilerleyebilmektedir [1,8]. Generalize DLE, periungual tutulum, antinükleer antikor (ANA) pozitifliği, eklem ağrısı, artmış sedimentasyon hızı, anemi, lökopeni, trombositopeni [9], bulunan hastalarda gelişim riski daha yüksektir [6].…”