Zosteriform impetigo: Wolf’s isotopic response in a cutaneous immunocompromised district

Abstract

Background:Impetigo can result from Staphylococcus aureus (S. aureus). Wolf’s isotopic response is the occurrence of a new cutaneous disorder at the site of a previously healed disease. A cutaneous immunocompromised district is an area of skin that is more vulnerable than the rest of the individual’s body.Purpose:To describe a man with impetigo localized to a unilateral dermatome and review the clinical features of other patients with zosteriform Staphylococcus aureus cutaneous infection.Methods:PubMed was used to search the following terms, separately and in combination: cutaneous, dermatome, dermatomal, district, herpes, immunocompromised, impetigo, infection, isotopic, response, skin, staphylococcal, Staphylococcus aureus, Wolf, zoster, zosteriform. All papers were reviewed and relevant manuscripts, along with their reference citations, were evaluated.Results:Crusted, eroded and intact, erythematous papules and nodules acutely presented localized to the mandibular branch of the left trigeminal nerve on the face of a 66-year-old man; he did not recall a prior episode of varicella-zoster virus infection in that area. A bacterial culture isolated methicillin-susceptible S. aureus. Viral cultures and direct fluorescent absorption studies were negative for herpes simplex and herpes zoster virus. All of the lesions resolved after oral treatment with cefdinir. Impetigo and/or furunculosis in a zosteriform distribution have also been described in 3 additional patients. The bacterial culture showed either methicillin-susceptible or methicillin-resistant S. aureus; the skin infection resolved after treatment with oral antibiotics; however one man experienced 2 recurrences in the same area.Conclusions:Zosteriform cutaneous staphylococcal impetigo may be an example of Wolf’s isotopic response in a cutaneous immunocompromised district

Basal cell carcinoma associated with non-neoplastic cutaneous conditions: a comprehensive review

“…For several conditions, the development of a BCC at the same site as the non-neoplastic cutaneous condition is probably unrelated to the condition; it merely represents the skin cancer occurring in an immunocompromised district of skin. Indeed, the BCC at the site may result from either a Koebner isomorphic response or the sequalae of a Wolf isotopic response [135][136][137][138][139][140][141].…”

“…In the original description, the healed skin disorder was a herpesvirus infection resulting from either herpes simplex virus or varicella-zoster virus. The isotopic response observed at the site of the prior herpesvirus infection include comedonic-microcystic reactions, dysimmune reactions, granulomatous reactions, infections, leukemic or lymphomatous infiltrations, other miscellaneous conditions, and malignant solid tumors (such as basal cell carcinoma), [137][138][139].…”

Basal Cell Carcinoma Originating in a Tattoo: Case Report and Review of an Uncommon Complication in Tattoo Recipients

“…An immunocompromised district describes an area of the skin that is more vulnerable to other dermatoses as compared with the rest of the body [18,19]. Local immune dysregulation-of variable etiologies-results in an immunocompromised district; the immune aberration can be genetic or acquired.…”