Carbamazepine-Induced Stevens-Johnson Syndrome Sparing the Skin Previously Affected by Herpes Zoster Infection in a Patient with Systemic Lupus Erythematosus: A Reverse Isotopic Phenomenon

Tenea, Daniela

doi:10.1159/000319628

Cited by 12 publications

(5 citation statements)

References 12 publications

(24 reference statements)

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“…Leukaemia cutis developed in healed herpes zoster-ophthalmic division of the trigeminal nerve. b Widespread purpuric macules and patches of Stevens-Johnson syndrome triggered by carbamazepine, sparing the right thoracic skin area previously affected by herpes zoster (reverse isotopic phenomenon) [22]. …”

Section: Lines Of Blaschkomentioning

confidence: 99%

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The Puzzle of the Skin Patterns

Tenea¹

2016

Integr Med Int

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Background: The pattern of distribution of skin diseases remains one of the most elusive problems in dermatology, particularly when multiple pathologies are involved and coexistence of patterns is present. Most skin diseases show a predilection for certain body areas and are located in characteristic patterns. Many dermatoses exhibit lesions in a segmental fashion concomitantly with disseminated patterns. Sometimes the sites of predilection are inexplicable. Objectives: The main purpose of this paper is to give an overview on the peculiar arrangement of cutaneous lesions in both congenital and acquired skin disorders as well as reactive phenomena in vulnerable areas, in order to better recognise them clinically and understand their pathogenesis. Methods: Based on personal observations and a review of literature, this paper summarises the basics in understanding the patterned distribution of skin lesions, highlights the significance of the lines of Blaschko and their relationship with mosaicism, and describes some of the reactive skin phenomena. Results: Skin mosaicism plays a crucial role in the distribution and arrangement of skin lesions, as demonstrated by recent advances in genetic research in an increasing number of various skin diseases.

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Section: Lines Of Blaschkomentioning

confidence: 99%

“…Pathogenically unrelated diseases may follow a zosteriform distribution if they are linked to a preceding herpes zoster infection by Koebner phenomenon, Renbok phenomenon, or an isotopic response [22,23] (Fig. 4b).…”

Section: Lines Of Blaschkomentioning

confidence: 99%

The Puzzle of the Skin Patterns

Tenea¹

2016

Integr Med Int

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“…Isotopic Nonresponse: In analogy to the isomorphic nonresponse the term "isotopic nonresponse," related to the isotopic response was introduced in the original contribution by same authors [16]. It is defined as the absence of an eruption at the site of another unrelated and already healed skin disease or the sparing of the sites of another unrelated and already healed skin disease [19][20][21][22][23].…”

Section: Koebner Nonreactionmentioning

confidence: 99%

Proposed classification for koebner, wolf isotopic, renbok, koebner nonreaction, isotopic nonreaction & other related phenomen.

Kannangara¹,

Yosipovitch²,

Fleischer³

2014

Dermatology Online Journal

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Students of skin diseases have long noted a variety of disease responses and non-responses to trauma and the presence of structural abnormalities. This article will review the series of these responses including: Koebner phenomenon, Wolf isotopic response, Renbök response, Koebner nonreaction, isotopic nonreaction, and other related skin reactions. Because most of these reported phenomena have similar morphological features the diagnosis is often made on the basis of differences in the clinical presentation. Note that some of the cutaneous reactions of similar phenomena have been described using varied nomenclature, further adding to the confusion. In view of this, we believe that at present there is a robust need to define each cutaneous reaction accordingly and classify the various types of these phenomena under a broad universal term or terms. Respecting the idea of differences might facilitate a better understanding of the pathophysiology of these entities. We then will propose an alternative classification system.

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“…Examples for this response are the case reports of Stevens-Johnson syndrome, erythema multiforme, and erythroderma sparing healed herpes zoster site. [19][20][21] The authors speculate that this may be related to the immune factors and/or to drug metabolism.…”

Section: Isotopic Non-responsementioning

confidence: 99%

Sparing phenomena in dermatology

Pakran¹

2013

Indian J Dermatol Venereol Leprol

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Despite considerable overlap, the confusion hovering over the four common sparing signs can be cleared as follows: Reverse Koebner relates to sparing by physical trauma; isotopic non-response/reverse isotopic response relates to sparing over an already healed dermatosis; Renbok Phenomenon relates to sparing among two concomitant active diseases often with autoimmune etiology; anatopic phenomenon relates to sparing caused by presence of certain infectious diseases of skin. In conclusion, sparing phenomenon of dermatology seems to command our attention by their sheer number, variety, and clinical implications. Therefore, it may be said that astute clinician is the one who will look, not only for the presence of lesions in the patient but also for the conspicuous absence thereof.

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Carbamazepine-Induced Stevens-Johnson Syndrome Sparing the Skin Previously Affected by Herpes Zoster Infection in a Patient with Systemic Lupus Erythematosus: A Reverse Isotopic Phenomenon

Cited by 12 publications

References 12 publications

The Puzzle of the Skin Patterns

The Puzzle of the Skin Patterns

Proposed classification for koebner, wolf isotopic, renbok, koebner nonreaction, isotopic nonreaction & other related phenomen.

Sparing phenomena in dermatology

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Carbamazepine-Induced Stevens-Johnson Syndrome Sparing the Skin Previously Affected by Herpes Zoster Infection in a Patient with Systemic Lupus Erythematosus: A Reverse Isotopic Phenomenon

Cited by 12 publications

References 12 publications

The Puzzle of the Skin Patterns

The Puzzle of the Skin Patterns

Proposed classification for koebner, wolf isotopic, renbok, koebner nonreaction, isotopic nonreaction &amp; other related phenomen.

Sparing phenomena in dermatology

Contact Info

Product

Resources

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Proposed classification for koebner, wolf isotopic, renbok, koebner nonreaction, isotopic nonreaction & other related phenomen.