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Koebner Phenomenon: Cafe-Au-Lait Spots Developing After a Secondary-Degree Burn in a Patient With Neurofibromatosis Type 1 Pubmed



Feily A1 ; Niaz MJ2 ; Fort M3 ; Moralescruz M4 ; Niaz MO5 ; Lange CS3, 6, 7 ; Ramirezfort MK2, 3, 6, 7
Authors

Source: Skinmed Published:2022


Abstract

An 18-year-old woman with an established history of neurofibromatosis type 1 (NF-1) presented for her 1-year dermatologic follow-up. Physical examination revealed two subcutaneous nodules on her right arm, axillary freckling, scattered cafe-au-lait macules (CALMs) on the trunk, and a 12 cm × 17 cm hyperpigmented rectangular region on her right flank (Figure 1). The pigmented patch contained numerous new CALMs that were morphologically consistent with CALMs identified on prior examinations; neither the patch nor the CALMs within it were present at prior examinations. Interestingly, the appearance of the patch and associated CALMs was preceded by a rectangular-shaped, second-degree thermal burn. On further questioning, the patient revealed that she had burned herself with hot water 4 months prior to her presentation in clinic, and noted the development of multiple CALMs within the skin area of her prior burn approximately 4 weeks after the incident. Of note, her left flank had sparsely scattered CALMs, which was consistent with her prior skin examinations (Figure 2). A depigmenting cream was to be applied to the rectangular pigmented patch; unfortunately, post-inflammatory hyperpigmentation from the burn and the adjoining lesions resulting from the Koebner phenomenon continue to be refractory to treatment.
2. Bullous Lesions on a Chronic Cutaneous Plaque, Clinical Cases in Autoimmune Blistering Diseases (2015)
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