[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-435673-105":59,"doc-detail-435673-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","bullous-pemphigoid-exhibiting-koebner-phenomenon","Bullous pemphigoid exhibiting Koebner phenomenon","","Bullous pemphigoid is a chronic autoimmune blistering disease that can be difficult to diagnose because its manifestations resemble other inflammatory dermatoses. Koebner phenomenon describes new lesions arising at previously unaffected sites after trauma, making its occurrence in bullous pemphigoid rare. The case describes an 83-year-old woman with ICU admission after acute cerebrovascular accident, who developed blisters at an itch-related site. Clinical exam and biopsy with histology and direct immunofluorescence supported bullous pemphigoid with Koebnerization.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/bullous-pemphigoid-exhibiting-koebner-phenomenon/435673/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/bullous-pemphigoid-exhibiting-koebner-phenomenon/435673.png","ImageObject",300,407,{"name":92,"@type":93},"anakgang17","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is the Koebner phenomenon in relation to this article?","Question",{"text":113,"@type":114},"Koebner phenomenon refers to new skin lesions appearing on previously unaffected skin areas due to trauma, producing lesions that are clinically and histologically similar to the patient’s existing condition.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was bullous pemphigoid diagnosed in the reported patient?",{"text":118,"@type":114},"Diagnosis was supported by a punch skin biopsy showing subepidermal split, with direct immunofluorescence demonstrating linear IgG and C3 deposition along the basement membrane.",{"name":120,"@type":111,"acceptedAnswer":121},"What treatment recommendations were provided for the patient’s blistering?",{"text":122,"@type":114},"Recommendations included elevating hands for edema, puncturing blisters to release fluid while preserving overlying skin, covering with a non-adherent dressing, applying mupirocin and mometasone, and using oral prednisone with tapering as described in the case.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},435673,1790766060,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":24,"preview_page_count":4},962090883568,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Letter to the Editor  \nBullous pemphigoid exhibiting Koebner phenomenon  \nZeinah Alhalees, MDa , Khalid Nabil Nagshabandi, MDb ,*, Abdulaziz Alsalhi, MDb  \nDear Editor,  \nBullous Pemphigoid (BP) is a chronic autoimmune blistering disease, primarily affecting the elderly, characterized by the formation of tense blisters on erythematous or normal skin[1]. The diagnosis of this condition can be particularly challenging, as it exhibits clinical manifestations that closely resemble those of a diverse array of other inflammatory disorders. The Koebner phenomenon (KP), initially identified by Heinrich Koebner in 1876, refers to the emergence of new skin lesions on areas of skin previously unaffected, as a result of trauma. This phenomenon is alternatively known as the isomorphic response – a term derived from the Greek word for “equal shape” – owing to the observation that the newly formed lesions are clinically and histologically indistinguishable from the lesions characteristic of the patient’s pre-existing dermatological condition[2]. KP is seen in various dermatological conditions like psoriasis, pemphigus vulgaris, and vitiligo, but rarely reported in BP. This article follows the TITAN Guidelines 2025 for the declaration and use of Artificial Intelligence in research reporting[3].  \nAn 83-year–old female with a complex medical history of diabetes mellitus, hypertension, dyslipidemia, osteoporosis, right total knee replacement (2018), and lumbar scoliosis with spondylolisthesis was admitted to the intensive care unit following an acute cerebrovascular accident. She had a low Glasgow coma scale (GCS) of 5 and required intubation since her admission. A dermatology team was consulted regarding the appearance of skin blisters at the site of itching during her ICU stay. Approximately 1 year prior to the current admission, the patient began experiencing itchiness without any associated rash. She was previously admitted to a private hospital 3 months prior, where she developed several blisters 2 weeks post-admission.  \naDepartment of Dermatology, King Faisal Specialist Hospital and Research Centre  \n(KFSHRC), Riyadh, Saudi Arabia and bDepartment of Dermatology, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.  \n*Corresponding author. Address: Dermatology Resident, Department of Dermatology, College of Medicine, King Saud University Medical City, PJ7C+89Q, 12482, Almugharazat, Riyadh 12372, Saudi Arabia. Tel.: +966 582940888.  \n[E-mail: khaloed23@gmail.com](E-mail: khaloed23@gmail.com) (K. N. Nagshabandi).  \nCopyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.  \nAnnals of Medicine & Surgery (2026) 88:965–966  \nReceived 26 October 2025; Accepted 31 October 2025  \nPublished online 17 November 2025  \n[http://dx.doi.org/10.1097/MS9.0000000000004315](http://dx.doi.org/10.1097/MS9.0000000000004315)  \nPhysical examination revealed intact linear clear-fluid containing blisters over the inner side of the left arm (Fig. 1) . Both hands were edematous. Mucous membranes and eyes are clear. A punch skin biopsy was obtained and histologic and direct immunofluorescence (DIF) findings showed subepidermal split and linear deposition of IgG and C3 along the basement membrane respectively, which were indicative of BP. She was diagnosed with bullous pemphigoid secondary to koebnerization. Recommendations included elevating the hands to relieve edema, puncturing the blisters to release fluid while leaving the overlying skin intact, and covering them with a non-adherent dressin","cbCaivBliIbn31W8","https://ap.wps.com/l/cbCaivBliIbn31W8","pdf",348376,"English","# Bullous pemphigoid and Koebner phenomenon\n## Case description and ICU course\n## Diagnosis and management recommendations","[{\"question\":\"What is the Koebner phenomenon in relation to this article?\",\"answer\":\"Koebner phenomenon refers to new skin lesions appearing on previously unaffected skin areas due to trauma, producing lesions that are clinically and histologically similar to the patient’s existing condition.\"},{\"question\":\"How was bullous pemphigoid diagnosed in the reported patient?\",\"answer\":\"Diagnosis was supported by a punch skin biopsy showing subepidermal split, with direct immunofluorescence demonstrating linear IgG and C3 deposition along the basement membrane.\"},{\"question\":\"What treatment recommendations were provided for the patient’s blistering?\",\"answer\":\"Recommendations included elevating hands for edema, puncturing blisters to release fluid while preserving overlying skin, covering with a non-adherent dressing, applying mupirocin and mometasone, and using oral prednisone with tapering as described in the case.\"}]","Bullous pemphigoid exhibiting Koebner phenomenon | PDF",1790674714]