The Koebner phenomenon may contribute to the development of calciphylaxis: A case series
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Authors
Gabel, Colleen K.Chakrala, Teja
Dobry, Allison S.
Garza-Mayers, Anna Cristina
Ko, Lauren N.
Nguyen, Emily D.
Shah, Radhika
St. John, Jessica
Nigwekar, Sagar U.
Kroshinsky, Daniela
UMass Chan Affiliations
Department of DermatologyDocument Type
Journal ArticlePublication Date
2021-04-28Keywords
IQRinterquartile range
Koebner phenomenon
Koebnerization
calciphylaxis
pathogenesis
risk factors
trauma
Dermatology
Nutritional and Metabolic Diseases
Pathological Conditions, Signs and Symptoms
Skin and Connective Tissue Diseases
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Calciphylaxis is characterized by calcific occlusion of vessels and subsequent tissue ischemia due to thrombosis. The precise pathogenetic mechanism behind calciphylaxis remains unclear. In the original experiment by Hans Selye and colleagues, soft-tissue calcification was induced in rats by applying a sensitizing agent, followed by a “challenger” agent after a specific time period. Trauma may represent one of these “challenger” agents, serving as an inducer of endothelial dysfunction and subsequent thrombosis, leading from tissue calcification to calciphylaxis. Koebnerization, a term used to describe the appearance of isomorphic lesions in areas of trauma, has been postulated to be a feature of calciphylaxis. This hypothesis arose from reports of patients who developed calciphylaxis following mild skin trauma, such as that caused by chronic resting of elbows on thighs, placement of ice packs, and injections involving various medications such as iron dextran, tobramycin, and especially insulin. Rigorous studies demonstrating the relationship between calciphylaxis and Koebnerization and an underlying mechanism are limited. To better understand this association, this study retrospectively identified characteristics of patients who presented with calciphylaxis in areas of trauma, suggesting the presence of Koebnerization.Source
Gabel CK, Chakrala T, Dobry AS, Garza-Mayers AC, Ko LN, Nguyen ED, Shah R, St John J, Nigwekar SU, Kroshinsky D. The Koebner phenomenon may contribute to the development of calciphylaxis: A case series. JAAD Case Rep. 2021 Apr 28;13:57-61. doi: 10.1016/j.jdcr.2021.04.016. PMID: 34159240; PMCID: PMC8193369. Link to article on publisher's site
DOI
10.1016/j.jdcr.2021.04.016Permanent Link to this Item
http://hdl.handle.net/20.500.14038/41884PubMed ID
34159240Related Resources
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Copyright © 2021 Published by Elsevier on behalf of the American Academy of Dermatology, Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Distribution License
http://creativecommons.org/licenses/by-nc-nd/4.0/ae974a485f413a2113503eed53cd6c53
10.1016/j.jdcr.2021.04.016
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Except where otherwise noted, this item's license is described as Copyright © 2021 Published by Elsevier on behalf of the American Academy of Dermatology, Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).