CASE REPORT   

Giornale Italiano di Dermatologia e Venereologia 1998 October;133(5):357-60

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: Italian

Koebner phenomenon in a vitiliginous patient caused by diabetic dermopathy. A case report

Hanke M. ¹, Monico S. ²

¹ Azienda USL n. 3, Ospedale S. Matteo degli Infermi - Spoleto (Perugia); ² Servizio di Anatomia e Istologia Patologica

The case of a patient, 34 year-old, male, suffering from insulindependent diabetes mellitus (IDDM) and diffuse vitiligo pre-existent to diabetes is described. The patient has noted, for years, the onset of erythematous patches in the lower limbs (from the knee to the foot) followed, after 4-5 months, in the same site and with the same shape, by a vitiligo patch. The patient was examined when a patch evolved toward an overt vitiligo and it was possible to document with photographs the evolution of the erythematous phase (still interesting the edges of the lesion), to the overt vitiligo. A biopsy of the erythematous patch pointed out aspecific changes that may be found in diabetic dermopathy. The clinical and histopathological examination, the evolution and localization of the lesions lead to diagnose vitiligo disease occurring as reactive isomorphism on the skin area affected by diabetic dermopathy. In particular, the histopathological changes of the dermo-epidermic junction and superficial derma of diabetic dermopathy can recall, as a traumatic, physical or chemical damage, Koebner’s phenomenon.