Yoon Ji Ha, Jang Ye Ji, Park Eun Joo, Kim Kwang Joong, Kim Kwang Ho
Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea.
Ann Dermatol. 2021 Apr;33(2):186-189. doi: 10.5021/ad.2021.33.2.186. Epub 2021 Mar 8.
Wolf's isotopic response refers to the occurrence of a novel skin disease at the site of a preceding treated or untreated skin disease. Although the most common preceding skin disease was found to be herpes zoster (HZ), HZ-related dermatological phenomena are not well known in the literature. We report a case of HZ granulomatous dermatitis in a 77-year-old female with a previous history of hypertension, diabetes mellitus, chronic kidney disease, and HZ. She presented with a 3-month history of a pruritic skin lesion on her right thigh. The location of the lesion was consistent with a previous HZ site. Histopathological examination revealed lympho- histiocytic infiltration in the superficial dermis, forming a granulomatous structure. Based on clinical and histopathological findings, we made a diagnosis of granulomatous dermatitis at a previous HZ site. We assumed that the lesion arose from an isotopic response of Wolf. The patient was treated with topical steroids for 3 months and showed clearance of the lesion and symptom. We suggest that treatment should be based on the individual disease, which in our case was topical steroid.
沃尔夫同位素反应是指在先前已治疗或未治疗的皮肤病部位出现一种新的皮肤病。虽然发现最常见的先前皮肤病是带状疱疹（HZ），但与HZ相关的皮肤病学现象在文献中并不为人熟知。我们报告一例77岁女性的HZ肉芽肿性皮炎病例，该患者既往有高血压、糖尿病、慢性肾病和HZ病史。她右大腿出现瘙痒性皮肤病变3个月。病变部位与先前的HZ部位一致。组织病理学检查显示浅表真皮有淋巴细胞-组织细胞浸润，形成肉芽肿结构。根据临床和组织病理学表现，我们诊断为先前HZ部位的肉芽肿性皮炎。我们推测该病变源于沃尔夫同位素反应。患者接受外用类固醇治疗3个月，病变和症状消退。我们建议治疗应基于个体疾病，在我们的病例中是外用类固醇。
