Koebner's phenomenon in systemic lupus erythematosus

Area of Science:

• Dermatology
• Immunology
• Rheumatology

Background:

• The Koebner phenomenon describes skin disease recurrence at sites of injury.
• Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse clinical presentations.
• Herpes zoster (shingles) can occur in immunocompromised individuals, including those with SLE.

Observation:

• A patient with new-onset SLE developed Herpes zoster while on immunosuppressants.
• Following Herpes zoster resolution, ulcerative lesions appeared at the scar site.
• The patient also experienced a worsening of her malar rash, characteristic of SLE.

Findings:

• The new skin lesions and malar rash exacerbation in the SLE patient were consistent with the Koebner phenomenon.
• This case highlights a potential association between Herpes zoster reactivation and Koebnerization in SLE.
• Literature review supports Koebner phenomenon occurring in SLE patients following various skin traumas.

Implications:

• Recognizing the Koebner phenomenon in SLE patients with viral infections is crucial for accurate diagnosis.
• This association may inform management strategies for skin manifestations in SLE.
• Further research is needed to elucidate the mechanisms linking viral infections, Koebner phenomenon, and SLE flares.