Wolf's Isotopic Response: A Case of Zosteriform Lichen Planus

Abstract

Lichen planus is a lichenoid disorder characterized by shiny, flat papules. In addition to the classical appearance, there are several variants. Zonal or zosteriform lesions have been described. A 25-year-old male with a complaint of increasing numbers of erythematous swellings on his left groin for twenty days was admitted to our out-patient clinic. He had a history of herpes zoster in the same localization which had been treated with topical acyclovir two weeks prior to his admission. Dermatological examination revealed multiple, shiny, erythematous, umblicated papules localized to the left inguinal region in a linear pattern. A biopsy was taken from the lesions. According to the clinical and pathological findings the diagnosis was zosteriform lichen planus. Zosteriform lichen planus is a rare variant of lichen planus; its differentiation from zona zoster and other linear dermatoses is difficult. We presented our case because of its rarity as a variant of lichen planus and its appearance in the area of healed herpes zoster as an isotopic response.

Wolf Isotopic Response Manifesting as Postherpetic Granuloma Annulare: A Case Series

“…3 These include leukemic infiltration, lymphoma, lichen planus, morphea, reactive perforating collagenosis, melanoma metastases, angiosarcoma, and infections. [4][5][6][7][8][9][10][11] Given this broad range of dermatologic disorders, including malignancy, that can present in a zosteriform distribution, a skin punch biopsy is recommended for confirming the diagnosis in clinically atypical cases.…”

Blaschkoid lichen planus in an adult Kashmiri male: a rare presentation

“…It seems that there exists a genetic pre-disposition to lichen planus and exposure to an appropriate enviromental or endogenous trigger may lead to the development of lichen planus. Blashkoid LP or the controversial zosteriform/ dermatomal LP may arise as koebner phenomena because of disseminated disease [10] or at site of previous healed zoster as wolf`s isotopic phenomena [6][7][8][9][12][13][14][15] or appear de novo [15][16][17] on previously normal non traumatized skin [18]. With the present available literature, it is difficult to differentiate the two terms with confidence.…”

A Variant of Wolf’s Isotopic Response - Overriding of Two Blistering Diseases

“…9 The usual second dermatoses include granuloma annulare, sarcoidosis, lichen planus, multiple epidermoid cysts, granulomatous folliculitis, and tinea infections etc. 5,6,7 Some authors have discussed a case of varicella lesions localizing at the site of pyoderma. This was considered to be a variant of the isotopic phenomenon.…”