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Ruocco's immunocompromised cutaneous district.

Vincenzo Piccolo1, Adone Baroni1, Teresa Russo1

  • 1Department of Dermatology and Venereology, Second University of Naples, Naples, Italy.

International Journal of Dermatology
|October 18, 2015
PubMed
Summary
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The concept of immunocompromised cutaneous districts (ICDs) explains why injured skin sites are prone to infections and tumors. This paper reviews the expanding spectrum of conditions associated with ICDs.

Area of Science:

  • Dermatology
  • Immunology
  • Pathology

Background:

  • The concept of 'locus minoris resistentiae' (lmr) describes a predisposition for diseases to occur at sites of prior injury.
  • The immunocompromised cutaneous district (ICD) is a newer concept explaining why previously injured skin becomes a privileged site for opportunistic infections, tumors, and immune reactions.
  • Ruocco et al. (2009) documented various disorders in ICDs, categorized by underlying causes like lymphedema, herpes infections (Wolf's isotopic response), and damaged areas (vaccination, radiation, burns, trauma).

Purpose of the Study:

  • To focus on the established pathogenic concept of immunocompromised cutaneous districts (ICDs).
  • To review the expanding spectrum of clinical conditions associated with ICDs.
  • To highlight the evolution of the 'locus minoris resistentiae' concept in dermatology.
Keywords:
Wolf's post-herpetic isotopic responsechronic lymph stasisimmunocompromised cutaneous districtlocoregional immune dysregulationlocus minoris resistentiaelymphedemaradiation dermatitis

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Main Methods:

  • Review of existing literature and case documentation on immunocompromised cutaneous districts.
  • Analysis of clinical settings contributing to local immune imbalance in previously injured skin.
  • Categorization of disorders based on etiological factors and clinical presentation.

Main Results:

  • The concept of ICD provides a framework for understanding disease localization in injured skin.
  • A wide range of infectious, neoplastic, and immune disorders have been documented in ICDs.
  • The understanding and application of the ICD concept have broadened significantly since its introduction.

Conclusions:

  • Immunocompromised cutaneous districts represent an established pathogenic concept in dermatology.
  • The spectrum of diseases occurring in ICDs is continually expanding.
  • The 'locus minoris resistentiae' principle, particularly as embodied by ICDs, remains a valuable tool for understanding cutaneous disease patterns.