Koebner

phenomenon

Heinrich Köbner (1838-1904)

The Koebner phenomenon or Köbner

phenomenon (pronunciation), also called
the Koebner response or the isomorphic
response, attributed to Heinrich Köbner,
is the appearance of skin lesions on lines
of trauma.[1] The Koebner phenomenon
may result from either a linear exposure
or irritation. Conditions demonstrating
linear lesions after a linear exposure to a
causative agent include: molluscum
contagiosum, warts and toxicodendron
dermatitis (a dermatitis caused by a
genus of plants including poison ivy).
Warts and molluscum contagiosum
lesions can be spread in linear patterns
by self-scratching ("auto-inoculation").
Toxicodendron dermatitis lesions are
often linear from brushing up against the
plant. Causes of the Koebner
phenomenon that are secondary to
scratching rather than an infective or
chemical cause include vitiligo, psoriasis,
lichen planus, lichen nitidus, pityriasis
rubra pilaris, and keratosis follicularis
(Darier disease).

Definition
The Koebner phenomenon describes skin
lesions which appear at the site of injury.
It is seen in:[2]

Psoriasis
Pityriasis rubra pilaris
Lichen planus
Flat warts
Lichen nitidus
 Vitiligo
Lichen sclerosus
Elastosis perforans serpiginosa
Kaposi sarcoma
Necrobiosis lipoidica
Systemic Lupus Erythematosus
Juvenile Idiopathic Arthritis
Still disease
Cutaneous leishmaniasis

A similar response occurs in pyoderma

gangrenosum and Adamantiades-
Behcet's syndrome, and is referred to as
pathergy.[2]

Rarely Koebner phenomenon has been

reported as a mechanism of acute
myeloid leukemia dissemination.[3]

Warts and molluscum contagiosum are

often listed as causing a Koebner
reaction, but this is by direct inoculation
of viral particles.[2]

The linear arrangement of skin lesions in

the Koebner phenomenon can be
contrasted to both lines of Blaschko and
dermatomal distributions. Blaschko lines
follow embryotic cell migration patterns
and are seen in some mosaic genetic
disorders such as incontinentia pigmenti
and pigment mosaicism. Dermatomal
distributions are lines on the skin surface
following the distribution of spinal nerve
roots. The rash caused by herpes zoster
(Shingles) follows such dermatomal
lines.

History
The Koebner phenomenon was named
after the rather eccentric but renowned
German dermatologist Heinrich
Koebner[4] (1838–1904). Koebner is best
known for his work in mycology. His
intense nature is illustrated by the
following: in a medical meeting, he
proudly exhibited on his arms and chest
three different fungus infections, which
he had self-inoculated, in order to prove
the infectiousness of the organisms he
was studying. The Koebner phenomenon
is the generalized term applied to his
discovery that on psoriasis patients, new
lesions often appear along lines of
trauma.

Pronunciation

A typical pronunciation in English

approximates the front rounded vowel ö
(/ø/ or /œ/) with an /r/ sound
(/ˈkɜːrbnər/).[5]

See also
Renbök phenomenon

References
1. Various grammatical forms of "Koebner
phenomenon" include: "Koebnerization",
and "to Koebnerize".
2. Cox, Gary M. White; Neil H. (2000).
Diseases of the skin : a color atlas and
text. London [u.a.]: Mosby. ISBN 0-7234-
3155-8.
3. Tendas A, Niscola P, Fratoni S, Cupelli L,
Morino L, Neri B, Ales M, Scaramucci L,
Giovannini M, Barbati R, Dentamaro T, de
Fabritiis P (Dec 2010). "Koebner's
phenomenon as a rare mechanism of
acute myeloid leukemia dissemination:
report of two cases with a brief overview".
Support Care Cancer. 18 (12): 1495–7.
doi:10.1007/s00520-010-1012-9 .
4. In the anglicisation of a German word,
double vowels are often substituted for
the Germanic umlaut on single vowels.
The transformation of "Köbner" to
"Kooebner" is just such a case. In the
English literature, the umlaut is simply
dropped and you often find "Köbner"
simply as "Kobner".
5. Elsevier, Dorland's Illustrated Medical
Dictionary , Elsevier.

Sources
Crissey JT, Parish LC, Holubar KH.
Historical Atlas of Dermatology and
Dermatologists. New York: The
Parthenon Publishing Group, 2002.
 Paller A, Mancini A. Hurwitz Clinical
Pediatric Dermatology. Philadelphia:
Elsevier Saunders, 2002.

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