Hwang Yiing-Feng, Wu Nai-Yuan, Lee Pei-Yuan
Department of Orthopedics Research Assistant Center, Show-Chwan Memorial Hospital, Changhua Institute of Biomedical Informatics, National Yang-Ming University, Taipei Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
Medicine (Baltimore). 2017 Oct;96(41):e8138. doi: 10.1097/MD.0000000000008138.
Trauma or surgical incision might cause Koebner phenomenon (KP) in patients with cutaneous diseases, but seldom studies reported KP induced by repeated orthopedic surgery.
The 22-year-old man did not have any prior histories of cutaneous diseases. Two months after the revision surgery for nonunion of the left femoral shaft fracture, KP was noted by psoriasis presented at the surgical scar, left thigh, scalp, and trunk. Phototherapy and topical treatments were prescribed but the effect was limited.
KP induced by failed revisional orthopedic surgery.
Because of implant failure, he underwent the second revision surgery, which was performed on the previous scar surrounded and covered by psoriatic plaques.
After the second revision surgery successfully corrected the orthopedic problem, the psoriatic lesion remitted along with the bone union.
In a patient having KP, to perform an operation on psoriatic lesion sites was safe and the surgical wound could heal well. The most important to treat KP induced by orthopedic surgery might be the underlying bone stability.
创伤或手术切口可能会在皮肤病患者中引发同形反应（KP），但很少有研究报道反复进行骨科手术会诱发KP。
该22岁男性既往无任何皮肤病病史。在左股骨干骨折不愈合翻修手术后两个月，在手术瘢痕、左大腿、头皮和躯干处出现银屑病，提示发生了KP。给予光疗和局部治疗，但效果有限。
骨科翻修手术失败诱发的KP。
由于植入物失败，他接受了第二次翻修手术，手术在先前被银屑病斑块包围和覆盖的瘢痕上进行。
第二次翻修手术成功纠正骨科问题后，银屑病病变随着骨愈合而缓解。
对于患有KP的患者，在银屑病病变部位进行手术是安全的，手术伤口能够良好愈合。治疗骨科手术诱发的KP，最重要的可能是潜在的骨稳定性。
