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Correspondence |

Koebner Phenomenon in Vitiligo: Not Always an Indication of Surgical Failure

Sanjeev V. Mulekar, MD; Marwan Asaad, MD; Bassel Ghwish, MD; Ahmed Al Issa, MD; Abdullah Al Eisa, MD
Arch Dermatol. 2007;143(6):799-816. doi:10.1001/archderm.143.6.801.
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The development of vitiligo at the site of physical injury such as cuts, abrasions, or surgical wounds is referred to as isomorphic Koebner phenomenon (IKP). The exact mechanism of IKP is not known. Surgical interventions are still considered useful only when lesions become refractory to medical treatment and are clinically stable. A positive finding on a minigraft test is an indication of future recovery after surgery.1 At the same time, it is important to note the absence of new koebnerization, including at the donor site for the minigrafting test. Koebnerization at the donor site is a warning sign about possible repigmentation failure after a surgical procedure.

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Repigmentation at the recipient area in spite of koebnerization at the donor site. A, Preoperative lesions on the malleolus; B, 6.5-month postoperative lesions on the malleolus; C, 5-month postoperative koebnerization at the donor site (lateral upper third of the thigh).

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