An unusual association between scalp psoriasis and ophiasic alopecia areata: the Renbök phenomenon

Criado, Paulo Ricardo; Valente, Neusa Yuriko Sakai; Michalany, N. S.; Martins, José Eduardo; Romiti, Ricardo; Aoki, Valéria; Vasconcellos, Cídia

doi:10.1111/j.1365-2230.2006.02351.x

Cited by 22 publications

(23 citation statements)

References 4 publications

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“…The Renbök phenomenon or inverse Köbner phenomenon refers to normal hair growth in psoriatic lesions observed in patients with coexisting psoriasis and alopecia areata. 1 It may be hypothesized that in severe psoriasis the immune system inhibits development of alopecia areata, in patients who would otherwise have the disease. Successful therapy of psoriasis may contribute to an immune switch, which facilitates alopecia areata in these patients.…”

Section: Figure 1 Hair Loss In the Patient Treated With Ustekinumab (mentioning

confidence: 99%

“…1 In both diseases an autoimmune process is the likely pathogenic mechanism, and both show at least partial response to classical immunosuppressive therapy. 2,3 Attempts to treat alopecia areata with biological, immunosuppressive, anti-psoriasis drugs, which target specific molecules, such as tumor necrosis alpha (adalimumab, etanercept, infliximab), CD2 (alefacept) or CD11a (efalizumab) were unsuccessful.…”

Section: Introductionmentioning

confidence: 99%

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Alopecia areata developing paralell to improvement of psoriasis during ustekinumab therapy

Słowińska¹,

Kardynał²,

Warszawik³

et al. 2010

J Dermatol Case Rep

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Background: Ustekinumab is a new immunosuppressive anti-psoriasis agent. The drug targets the p40 subunit of IL-12 and IL-23 and indirectly inhibits cytokine production by Th17 cells.Main Observations: We present a case of a 36-year-old male patient with psoriasis, who received ustekinumab therapy, applied in 45mg subcutaneous injections at week 0, 4 and than every 12 weeks. After 7 months of therapy PASI decreased from 10,1 to 0,9. At this phase of therapy he developed two patches of alopecia areata on the scalp. The diagnosis was made based on clinical appearance and was confirmed by trichoscopy (hair and scalp dermoscopy) and reflectance confocal microscopy. The development of alopecia areata was preceded by emotional stress and dental infection.Conclusion: Ustekinumab seems an unlikely cause of alopecia areata in this patient. However, lack of efficacy is preventing hair loss may indicate that interleukin-12 cytokine family is not a key player in pathogenesis of alopecia areata.

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Section: Figure 1 Hair Loss In the Patient Treated With Ustekinumab (mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Alopecia areata developing paralell to improvement of psoriasis during ustekinumab therapy

Słowińska¹,

Kardynał²,

Warszawik³

et al. 2010

J Dermatol Case Rep

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“…Apesar de a histopatologia evidenciar dermatite psoriasiforme, a cronicidade das lesões e a resistência a qualquer forma de intervenção terapêutica o diferenciam da psoríase linear. 6,20 A psoríase pustulosa é rara em crianças. Caracteriza-se por múltiplas pústulas, estéreis, sobre base eritematosa.…”

Section: Aspectos Clínicosunclassified

“…Doentes Köbner-positivos classicamente não apresentam o fenômeno de Renbök; os dois eventos parecem mutuamente exclusivos. 20 Não existe exame laboratorial específico para o diagnóstico de psoríase1. O quadro histológico não é específico, porém é bastante sugestivo.…”

Section: Diagnósticounclassified

Psoríase na infância e na adolescência

Romiti

Maragno

Arnone

et al. 2009

An. Bras. Dermatol.

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Resumo: A psoríase é doença inflamatória crônica, imunologicamente mediada, recorrente e de caráter universal. Aproximadamente um terço dos adultos acometidos refere início da doença antes dos 16 anos de idade. Quanto mais precoce, mais grave tende a ser a evolução do quadro. Em crianças, as lesões podem ser fisicamente desfigurantes, causando prejuízos psicológicos e evidente comprometimento da qualidade de vida. As medicações sistêmicas utilizadas na psoríase, bem como a fototerapia, têm indicação limitada na infância, devido aos efeitos cumulativos das drogas, à baixa aceitação e ao risco de teratogenicidade. Nesta seção, discutiremos as principais manifestações clínicas da psoríase na infância e na adolescência, bem como os diagnósticos diferenciais, opções terapêuticas e prognóstico. Palavras-chave: Adolescente; Criança; Epidemiologia; Infância; Psoríase; Quadro clínico; Terapêutica Abstract: Psoriasis is a chronic, immunologically mediated, recurrent and universal inflammatory disorder. Approximately one third of adults refer onset before 16 years of age. The sooner the onset, the worse is the prognosis. In children, lesions may be physically disfiguring, leading to psychological impairment and evident loss of quality of life. Systemic therapy used in psoriasis, as well as phototherapy, has limited use in children due to accumulative effects of drugs, low acceptance, and risk of teratogenicity. In this section, we discuss the main clinical aspects of psoriasis in childhood and adolescence, differential diagnosis, therapeutic options, and prognosis.

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“…A variety of other related observations have also been reported. The Renbok Phenomenon or "Inverse Koebner Phenomenon" was described as normal hair growth in psoriatic patches noted in patient with co-occurrence of psoriasis and alopecia areata [4][5][6][7]. In 1995 Wolf et al introduced "Isotopic nonresponse" to describe the absence of an eruption at the site of another, unrelated, and already healed skin disease in their article of "Isotopic response" [8].…”

Section: Introductionmentioning

confidence: 99%

The Sparing Phenomenon. A case series of the inverse Koebner and related phenomena

Kannangara¹,

Fleischer²,

Yosipovitch³

2013

Our Dermatol Online

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Introduction:The sparing of the involvement of a cutaneous disease in a site that has been previously subjected to a skin disease, congenital nevus or physical insult has been reported in literature by various names, including the inverse Koebner phenomenon. Objectives: To review cases that we have seen and to document the reported cases and unify them with a single term, the "Sparing phenomenon". Materials and Methods:We report four new examples of this phenomenon and performed a PubMed literature search on related search terms and summarized the reported cases. Results: We report four new cases of this phenomenon. An additional 16 reported cases of the sparing phenomenon were identified. Herpes zoster was the most reported inflammatory disease site followed by; skin irradiation was the commonly documented physical insult. Drug reactions and psoriasis were the most common diseases that spare these sites. The time gap between first and second insult was highly variable. Conclusions: We proposed the term "Sparing phenomenon" to describe the skin disease sparing on an area which was previously subjected to skin disease or physical insult. By introducing this new term to the dermatology glossary, it would be easy to collect and analysis to understand the immuno-pathophsiology of this skin reaction described in various names.

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An unusual association between scalp psoriasis and ophiasic alopecia areata: the Renbök phenomenon

Cited by 22 publications

References 4 publications

Alopecia areata developing paralell to improvement of psoriasis during ustekinumab therapy

Alopecia areata developing paralell to improvement of psoriasis during ustekinumab therapy

Psoríase na infância e na adolescência

The Sparing Phenomenon. A case series of the inverse Koebner and related phenomena

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