Koebner Phenomenon Psoriasis after Right Ankle Free Flap Reconstruction

Area of Science:

• Dermatology
• Plastic Surgery
• Surgical Oncology

Background:

• The Koebner phenomenon describes isomorphic skin lesion development following trauma in individuals with pre-existing skin conditions.
• While documented in various dermatoses, its occurrence after lower extremity flap reconstruction is not previously reported.
• This phenomenon involves the manifestation of skin conditions at sites of injury.

Purpose of the Study:

• To report a rare case of the Koebner phenomenon occurring after anterolateral thigh free flap reconstruction for sarcoma excision.
• To emphasize the importance of interdisciplinary collaboration between plastic surgery and dermatology in managing postoperative dermatological complications.

Main Methods:

• A case study of a 24-year-old male patient undergoing right ankle reconstruction with an anterolateral thigh flap.
• Clinical observation and dermatological diagnosis of plaque psoriasis attributed to Koebnerization at flap and donor sites.
• Treatment with topical corticosteroids.

Main Results:

• The patient developed plaque psoriasis at the flap and donor sites 6 months post-reconstruction, consistent with the Koebner phenomenon.
• Treatment with topical corticosteroids led to complete resolution of the lesions within 2 days.
• No recurrence was observed at the 8-month follow-up, with all surgical sites healed.

Conclusions:

• This case represents a rare instance of the Koebner phenomenon following free flap reconstruction in a patient with no prior history of psoriasis.
• Prompt dermatological evaluation and management are critical for resolving postoperative dermatoses and ensuring favorable surgical outcomes.
• Early detection and treatment can prevent unnecessary interventions and complications.