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Dermatology

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Miscellaneous

Question
1 out of 10
 

‘Pseudo-isomorphic’ phenomenon is seen with? (LQ)



A Vitiligo
B Lichen planus

C Psoriasis
D Warts


Ans. D
Warts.

Pseudo-koebner’s or pseudo-isomorphic phenomenon is seen with Warts.

Isomorphic Phenomenon:
1). Also called Koebner’s phenomenon.

2). Development of isomorphic pathologic lesions in the traumatized uninvolved skin of patients who have cutaneous diseases.

3). Types:

1.True isomorphic phenomenon

Psoriasis, lichen planus and vitiligo.

2.Psuedoisomorphic phenomenon

seen in infectious diseases like warts, molluscum contagiosum.

Also seen in pyoderma gangrenosum and Behcet’s disease

3.Occasionally occurring isomorphic phenomenon

Darier’s disease. kyrle’s disease, pellagra, kaposi’s sarcoma,

erythema multiforme, Hailey-Hailey disease.

4. Causes:

a. Mechanical or thermal trauma b. Allergic or irritant reactions

c. Dermatosis d. Grenz ray therapy,X ray therapy

5. Develops within 10-14 days but may take 3 days to several years

6. Clinical significance:signifies activity of the disease

- Reverse Koebner response: lesions clear following injury; seen in psoriasis.

Well-known signs in psoriasis:

CLASSICAL FEATURES OF PSORIASIS:

a. Silver mica scales Q b. Auspitz sign (in plaque type)Q

c. Candle grease sign d. Grattage sign

e. Koebner;s phenomenon Q f. Thimble pitting of nails Q

g. Onycolysis h. Oil-drop nails Q

i. Arthritis mutilans Q j. Warnoff ring Q

k. Munro Microabscesses l. Suprapapillary thinning Q

m. ParakeratosisQ

Auspitz sign

Presence of pinpoint bleeding at the base of a plaque after scale is forcibly removed.

Can also be seen in other disorders.

Woronoff ’s ring

Presence of a white ring around erythematous plaques undergoing topical treatment or phototherapy.

Isomorphic or Köbner phenomenon

Development of lesions at sites of trauma, including those from sunburn.

1). Iris or target lesions = Erythema multiformie

2). Bulla spread sign and Nikolsky’s sign = Pemphigus vulgaris.

3). Auspitz sign = Plaque Psoriasis.

4). Darrier’s sign = Urticaria pigmentosa.

5). White dermographism = Atopic dermatitis.

6). Dimple sign = Dermatofibroma.



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