Zosteriform lichen planus after healed herpes zoster: Report of a new case of Wolf\'s isotopic phenomenon

Abstract

 "The wolf isotopic phenomenon corresponds to the appearance of a skin disease in a place on the body that was previously affected by another, already healed dermatosis." A 35-year-old woman presented with a transversely distributed zosteriform eruption about 12 to 14 cm in length, consisting of erythematous, scaly, moderately pruritic papules on the left flank that spread to the back (does not cross the midline) for several weeks after locally healed herpes zoster (HZ) lesions. No other skin or mucosal sites were included. Routine examination of blood, urine and stool showed no abnormality. A biopsy sample was taken from one of the lesions. Histopathological examination showed typical lichen planus changes, confirming the diagnosis of post-Herpes zoster zosteriform lichen planus (ZLP). The lesions resolved after treatment with topical steroids. Zosteriform lichen planus (ZLP) is an example of a Wolf isotopic phenomenon appearing after HZ at the same site. The exact pathogenesis of ZLP is unknown, it is assumed that persistent viral proteins could be responsible for the hypersensitivity reaction.