Dermatology Online Journal
What is the mechanism of Koebner phenomenon in Henoch-Schönlein purpua?
- Author(s): Shin, Jae Il
- Lee, Jae Seung
- et al.
What is the mechanism of Koebner phenomenon in Henoch-Schönlein purpua?Department of Pediatrics, The Institute of Kidney Disease, Yonsei University College of Medicine, Severance Children's Hospital,
Seoul, Korea. email@example.com
Jae Il Shin MD, Jae Seung Lee MD
Dermatology Online Journal 14 (12): 17
Comment on: Koebner's phenomenon in Henoch-Schönlein purpura and role of pressure in its causation. (Dermatol Online J. 2007 May 1;13(2):26.)
Although the exact mechanism of the Koebner phenomenon has not been elucidated in Henoch-Schönlein purpura (HSP), tryptase (a marker for mast cell activation) may play an important role in the pathogenesis.
We read with interest the article by van Nischal et al . They reported a 42-year-old male with Henoch-Schönlein purpura (HSP) showing Koebner's phenomenon , but the exact patho-mechanism was not elucidated. Namazi  reported that increase of tryptase levels following trauma could also provide a mechanism for the Koebner phenomenon seen in psoriasis and Naukkarinen et al.  also showed that mast cell tryptase and chymase are potential regulators of neurogenic inflammation in psoriatic skin. Therefore, tryptase may play an important role in the pathogenesis of the Koebner phenomenon. Although not extensively studied in vasculitis, recent studies showed that immuno-enzyme-histological staining of tryptase (a marker for mast cell activation) was found in cutaneous allergic vasculitis  or HSP nephritis . Therefore, further studies should be performed to elucidate the relationship between mast cell activation and the Koebner phenomenon in the acute stage of HSP.
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