Could It be Wolf Isotopic Response?

Abstract

Wolf isotopic response is the occurrence of new dermatoses on areas of the skin with previous but still active dermatoses. Vitiligo is an acquired disorder characterized by the loss of functional melanocytes which manifests as circumscribed depigmented macules and patches. Dermatophytoses are superficial fungal infections caused by three genera of fungi ( Microsporum , Trichophyton , and Epidermophyton ) that have the unique ability to invade and multiply within keratinized tissue (skin, hair, and nail). The appearance of dermatophyte infection on previously present vitiligo lesion is an uncommon example of Wolf response. We describe a case series of five vitiligo patients that presented to our OPD over 1 year period.

Clinicopathologic Overlap of Vulvar Psoriasis and Candidiasis

“…23,24 A subtype of koebnerization is the Wolf isotopic response, defined as the appearance of a new dermatosis in the same place as an unrelated lesion, initially described as infections or immune disorders within resolving herpes zoster. 25 The tricolor vulva of psoriasis superimposed on vitiligo may represent a Wolf response. 15 Another relevant example involves a patient with intertriginous rash and positive C. albicans culture who improved with antifungals, then recurred with a negative culture and responded to psoriasis treatment.…”

“…The vulva is exposed to numerous koebnerizing events to include minor surgery, sexual friction, hair management, and contact dermatitis 23,24 . A subtype of koebnerization is the Wolf isotopic response, defined as the appearance of a new dermatosis in the same place as an unrelated lesion, initially described as infections or immune disorders within resolving herpes zoster 25 . The tricolor vulva of psoriasis superimposed on vitiligo may represent a Wolf response 15 .…”