Koebner's phenomenon in burns: another complication following thermal injury

Khan, James; Frame, James D.

doi:10.1016/0305-4179(93)90162-2

Cited by 8 publications

(2 citation statements)

References 4 publications

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“…Immunosuppression after severe burn injuries is well recognized as underlying postburn susceptibility to serious bacterial infections, but a lesser recognized consequence of burn injuries is local susceptibility to viral infections, such as human papilloma virus (HPV), which manifests as verrucae developing at former burn sites. Only a few such cases have been previously reported, two of which described the appearance of verrucae at healed burn sites 6 months after burn injuries that had healed by epidermal grafting or conservative measures . In another similar case, a large verruca appeared at a healed burn site 4 weeks after a child had sustained a burn injury at the site of an active verrucous lesion .…”

Section: Discussionmentioning

confidence: 99%

Verrucae Planae Within Previous Xenograft Sites of Burn Wounds

Chen

Pearlstein

Morrell

et al. 2017

Pediatric Dermatology

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Burn injuries are known to compromise host immune defenses through disruption of mucocutaneous barriers and suppression of cell-mediated immune responses, which may render patients with burn injuries susceptible to viral infections in the days to years after an initial insult. We report a case of verrucae planae developing as a secondary condition confined to former xenograft sites in a child, appearing more than 3.5 years after initial second-degree burn injuries. Only a few reports have previously described the development of verrucae in former burn sites, with most reporting latency to onset of verrucae appearance of months rather than years. Current hypotheses suggest that the postburn immune response shifts from an early proinflammatory to a late antiinflammatory response characterized by altered cytokine profiles and diminished cellular cytotoxicity mediated by cytotoxic T-lymphocytes, natural killer cells, and epidermal antigen-presenting cells, which together likely contribute to an enduring postburn regional immunosuppression that allows for the seeding and proliferation of viral agents.

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Section: Discussionmentioning

confidence: 99%

Verrucae Planae Within Previous Xenograft Sites of Burn Wounds

Chen

Pearlstein

Morrell

et al. 2017

Pediatric Dermatology

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“…In our patient, the warts appeared in sites around the graft. This fact led us to suppose that there could be several factors implicated in the infection: the patient had a latent infection before the burn and it spread by the Koebner phenomenon (2); the infection took place during surgery, by human contagion, or by a contaminated instrument (3) that would have preferably acted on the recipient site around the injury; the infection took place in the immediate postoperative period, before the removal of the pressure dressings from the grafted site; or the infection occurred in the late postoperative period, transmitted by close human contact.…”

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confidence: 99%