Causes of Koebner's Phenomenon

Symptoms and treatments of 4 common tyes of skin lesions

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Koebner's Phenomenon occurs when trauma to the skin causes a skin lesion. The amount of trauma required can be very small—sometimes just rubbing the skin can cause a lesion to develop. It was first described by Heinrich Koebner in 1876.

Koebner's phenomenon, also called isomorphic phenomenon or isomorphic reaction, is seen most often in psoriasis, eczema, lichen planus, and vitiligo.


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Psoriasis on elbows
Psoriasis on elbows. Jodi Jacobson / Getty Images

Psoriasis is a common skin condition that changes the life cycle of skin cells. Psoriasis causes cells to build up rapidly on the surface of the skin. The extra skin cells form thick, silvery scales and itchy, dry, red patches that are sometimes painful.

Psoriasis is a persistent, long-lasting (chronic) disease. There may be times when your psoriasis symptoms get better alternating with times your psoriasis worsens.

The primary goal of treatment is to stop the skin cells from growing so quickly. While there isn't a cure, psoriasis treatments may offer significant relief. Lifestyle measures, such as using a nonprescription cortisone cream and exposing your skin to small amounts of natural sunlight, also may improve your psoriasis symptoms.


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Atopic dermatitis in a child
Discoid eczema rash. OlegMalyshev / Getty Images

Atopic dermatitis (eczema) is a condition that makes your skin red and itchy. It's common in children but can occur at any age. Atopic dermatitis is long-lasting (chronic) and tends to flare periodically and then subside. It may be accompanied by asthma or hay fever.

No cure has been found for eczema. But treatments and self-care measures can relieve itching and prevent new outbreaks. For example, it helps to avoid harsh soaps and other irritants, apply medicated creams or ointments, and moisturize your skin.

See your healthcare provider if your eczema symptoms distract you from your daily routines or prevent you from sleeping.

Lichen Planus

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Lichen Planus
Lichen Planus. TimoninaIryna / Getty Images

Lichen planus is an inflammatory condition that can affect the skin, hair, nails and mucous membranes. On the skin, lichen planus usually appears as purplish, often itchy, flat-topped bumps. In the mouth, vagina and other areas covered by a mucous membrane, lichen planus forms lacy white patches, sometimes with painful sores.

Most people can manage typical, mild cases of lichen planus at home without medical care. If the condition causes pain or significant itching, is severe or widespread, and/or is in certain areas (e.g., the genital area), you will likely need to use a prescription drug.


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Close-Up Of Hands With Vitiligo
Vitiligo. Axel Bueckert / EyeEm / Getty Images 

Vitiligo is a disease that causes the loss of skin color in blotches. The extent and rate of color loss from vitiligo is unpredictable. It can affect the skin on any part of your body. It may also affect hair, the inside of the mouth, and even the eyes.

Normally, the color of hair, skin, and eyes is determined by melanin. Vitiligo occurs when the cells that produce melanin die or stop functioning.

Vitiligo affects people of all skin types, but it may be more noticeable in people with darker skin. The condition is not life-threatening or contagious. Treatment for vitiligo may improve the appearance of the affected skin but does not cure the disease.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Sanchez DP, Sonthalia S. Koebner Phenomenon. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. 

  2. National Psoriasis Foundation. What is psoriasis?

  3. Mayo Clinic. Psoriasis—Symptoms & Causes.

  4. Mayo Clinic. Psoriasis—Diagnosis & Treatment.

  5. National Eczema Association. What is Eczema?

  6. American Academy of Dermatology Association. Lichen Planus: Signs and Symptoms.

  7. Usatine RP, Tinitigan M. Diagnosis and treatment of lichen planus. Am Fam Physician. 2011 Jul 1;84(1):53-60. PMID: 21766756.

  8. American Academy of Dermatology Association. Vitiligo: An Overview.

  9. Mayo Clinic. Vitiligo.

By Heather L. Brannon, MD
Heather L. Brannon, MD, is a family practice physician in Mauldin, South Carolina. She has been in practice for over 20 years.