Koebner Phenomenon Induced by Eyeglasses in a Patient With Discoid Lupus Erythematosus

The Koebner phenomenon, or isomorphic response, refers to the induction of disease-specific lesions on uninvolved skin following trauma. This phenomenon is well-documented across several dermatologic conditions such as psoriasis and vitiligo but is less recognized in discoid lupus erythematosus (DLE). We report a case of a 37-year-old African American woman with DLE, triggered by repeated contact with eyeglass frames, leading to the development of discoid lesions at the points of pressure on her face. This case is a rare occurrence of Koebnerization in DLE, diagnosed through characteristic histopathological findings and supported by serological evidence. Her management included hydroxychloroquine, topical corticosteroids, and methotrexate due to disease flaring. Eventually, she developed systemic lupus erythematosus, complicating her clinical course. This case discusses the need for awareness regarding Koebnerization in DLE and its potential role in indicating active disease or predicting transition to systemic involvement. Further research is necessary to explore the pathogenic mechanisms and implications of Koebnerization in DLE, emphasizing the importance of preventive measures against mechanical trauma in susceptible individuals.