ISSN: 1859 - 2872
Sparing phenomenon in dermatology: Case reports and literature review
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Tóm tắt
Sparing phenomenon in dermatology is the phenomenon that the skin lesions of existing skin diseases do not appear in skin areas with certain characteristics. This phenomenon is recorded across various skin diseases. It is not only serve as a helpful clinical sign in the differential diagnosis of multiple dermatological conditions but also opens up a direction for further research on the pathogenesis of disease that remain poorly understood. Moreover, it may suggest the possibility of application in new treatment therapies. In Vietnam, this phenomenon has been rarely discussed in the literature. In this article, we present three clinical cases with sparing phenomenon and provide an overview of this finding based on international literature.
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Các tài liệu tham khảo
1. Kannangara AP, Fleischer AB, Yosipovitch G (2013) The Sparing Phenomenon. A case series of the inverse Koebner and related phenomena. Our Dermatology Online 4(1): 35-39. doi: 10.7241/ourd.20131.07
2. RJ C, JK W (1981) Failure of drug rash to appear in a previously irradiated site. Arch Dermatol 117(12): 810-811. doi:10.1001/ARCHDERM.117.12.810
3. Pakran J (2013) Sparing phenomena in dermatology. Indian J Dermatol Venereol Leprol. 79(4): 545-550. doi:10.4103/0378-6323.113104.
4. Griffiths CEM, Bleiker TO, Creamer D, Ingram JR, Simpson RC (2022) Rook’s Dermatology Handbook. Wiley-Blackwell.
5. Jazdarehee A, Lee J, Lewis R, Mukovozov I (2022) Potential Mechanisms of the Sparing of Atopic Dermatitis in the Diaper Region: A Scoping Review. J Cutan Med Surg 26(4): 398. doi:10.1177/12034754221088533
6. Sargen MR, Hoffstad O, Margolis DJ (2014) Warm, humid, and high sun exposure climates are associated with poorly controlled Eczema: PEER (Pediatric Eczema Elective Registry) Cohort, 2004-2012. Journal of Investigative Dermatology 134(1): 51-57. doi: 10.1038/JID.2013.274
7. Shiohara T, Shimoda-Komatsu Y, Mizukawa Y, Hayashida Y, Aoyama Y. The role of sweat in the pathogenesis of atopic dermatitis. Evolution of Atopic Dermatitis in the 21st Century. Published online December 6, 2017:125-140. doi:10.1007/978-981-10-5541-6_11
8. Shiohara T, Mizukawa Y, Shimoda-Komatsu Y, Aoyama Y (2018) Sweat is a most efficient natural moisturizer providing protective immunity at points of allergen entry. Allergology International 67(4): 442-447. doi:10.1016/J.ALIT.2018.07.010
9. Nakatsuji T, Chen TH, Narala S et al (2017) Antimicrobials from human skin commensal bacteria protect against Staphylococcus aureus and are deficient in atopic dermatitis. Sci Transl Med 9(378). doi:10.1126/SCITRANSLMED.AAH4680
10. Ong PY, Ohtake T, Brandt C et al (2002) Endogenous Antimicrobial Peptides and Skin Infections in Atopic Dermatitis. New England Journal of Medicine 347(15): 1151-1160. doi:10.1056/NEJMOA021481
11. Wollenberg A, Fölster-Holst R, Saint Aroman M, Sampogna F, Vestergaard C (2018) Effects of a protein-free oat plantlet extract on microinflammation and skin barrier function in atopic dermatitis patients. Journal of the European Academy of Dermatology and Venereology 32: 1-15. doi:10.1111/JDV.14846
12. Jia WX, Mao QX, Xiao XM, Li ZL, Yu RX, Li CR. Patchy alopecia areata sparing gray hairs: a case series. Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii. 2014;31(2):113. doi:10.5114/PDIA.2014.40956
13. Mohamad Aljabre SH (2005) Sparing of the upper axillary area in pityriasis versicolor. Rev Iberoam Micol 22(3): 167-168. doi: 10.1016/s1130-1406(05)70033-4
14. Byrd AL, Belkaid Y, Segre JA (2018) The human skin microbiome. Nat Rev Microbiol 16(3): 143-155. doi: 10.1038/NRMICRO.2017.157,
15. Staser K, Ezra N, Sheehan MP, Mousdicas N (2014) The beak sign: A clinical clue to airborne contact dermatitis. Dermatitis 25(2): 97-98. doi:10.1097/DER.0B013E3182A8ADA3.
16. Agarwal S, Khullar R, Kalla G, Malhotra YK (1992) Nose Sign of Exfoliative Dermatitis: A Possible Mechanism. Arch Dermatol 128(5): 704-704. doi:10.1001/ARCHDERM.1992.01680150138029
17. Mohapatra L, Samal K, Mohanty P, Dash S (2019) Reverse koebner phenomenon in bullous pemphigoid - A case report. Indian Dermatol Online J. 10(6): 692-694. doi:10.4103/idoj.IDOJ_512_18
18. Yadav S, De D, Kanwar A (2011) Reverse koebner phenomenon in leukocytoclastic vasculitis. Indian J Dermatol 56(5): 598. doi:10.4103/0019-5154.87169
19. Khan AS, Badar Q, Siddiqui K, Hanif S, Lakhan H (2024) Reverse Koebner Phenomenon in a Vitiligo Patient Treated With Radiotherapy. Cureus 16(5): 60771. doi:10.7759/CUREUS.60771
20. Sferopoulos NK (2016) Reverse Koebner Phenomenon Following Conservative Treatment of a Tibial Fracture. ARC Journal of Orthopedics 1(2): 24-26. doi:10.20431/2456-0588.0102004
21. Martín JM, Conde A, Pinazo I et al (2006) Reverse koebnerization after radiotherapy in a woman with a mastectomy for a breast carcinoma. J Am Acad Dermatol. 55(5 SUPPL.). doi:10.1016/J.JAAD.2004.03.042
22. Nasca MR, Micali G, Ferrau F (1995) Steroid acne sparing an area of previous irradiation [2]. Acta Derm Venereol 75(6): 495. doi:10.2340/0001555575495.
23. Mansur AT, Aydingöz IE (2009) Reverse isotopic response: A rarely reported phenomenon. Int J Dermatol 48(7): 783-784. doi: 10.1111/J.1365-4632.2009.04014.X.
24. Nemazee L, Harries M (2021) Frontal fibrosing alopecia sparing a vascular naevus: The Renbök phenomenon. Clin Exp Dermatol 46(4): 727-728. doi:10.1111/CED.14501.
25. Pakran J, Riyaz N (2011) Interesting effect of Malassezia spp. infection on dermatoses of other origins. Int J Dermatol 50(12): 1518-1521. doi:10.1111/J.1365-4632.2011.04945.X.
2. RJ C, JK W (1981) Failure of drug rash to appear in a previously irradiated site. Arch Dermatol 117(12): 810-811. doi:10.1001/ARCHDERM.117.12.810
3. Pakran J (2013) Sparing phenomena in dermatology. Indian J Dermatol Venereol Leprol. 79(4): 545-550. doi:10.4103/0378-6323.113104.
4. Griffiths CEM, Bleiker TO, Creamer D, Ingram JR, Simpson RC (2022) Rook’s Dermatology Handbook. Wiley-Blackwell.
5. Jazdarehee A, Lee J, Lewis R, Mukovozov I (2022) Potential Mechanisms of the Sparing of Atopic Dermatitis in the Diaper Region: A Scoping Review. J Cutan Med Surg 26(4): 398. doi:10.1177/12034754221088533
6. Sargen MR, Hoffstad O, Margolis DJ (2014) Warm, humid, and high sun exposure climates are associated with poorly controlled Eczema: PEER (Pediatric Eczema Elective Registry) Cohort, 2004-2012. Journal of Investigative Dermatology 134(1): 51-57. doi: 10.1038/JID.2013.274
7. Shiohara T, Shimoda-Komatsu Y, Mizukawa Y, Hayashida Y, Aoyama Y. The role of sweat in the pathogenesis of atopic dermatitis. Evolution of Atopic Dermatitis in the 21st Century. Published online December 6, 2017:125-140. doi:10.1007/978-981-10-5541-6_11
8. Shiohara T, Mizukawa Y, Shimoda-Komatsu Y, Aoyama Y (2018) Sweat is a most efficient natural moisturizer providing protective immunity at points of allergen entry. Allergology International 67(4): 442-447. doi:10.1016/J.ALIT.2018.07.010
9. Nakatsuji T, Chen TH, Narala S et al (2017) Antimicrobials from human skin commensal bacteria protect against Staphylococcus aureus and are deficient in atopic dermatitis. Sci Transl Med 9(378). doi:10.1126/SCITRANSLMED.AAH4680
10. Ong PY, Ohtake T, Brandt C et al (2002) Endogenous Antimicrobial Peptides and Skin Infections in Atopic Dermatitis. New England Journal of Medicine 347(15): 1151-1160. doi:10.1056/NEJMOA021481
11. Wollenberg A, Fölster-Holst R, Saint Aroman M, Sampogna F, Vestergaard C (2018) Effects of a protein-free oat plantlet extract on microinflammation and skin barrier function in atopic dermatitis patients. Journal of the European Academy of Dermatology and Venereology 32: 1-15. doi:10.1111/JDV.14846
12. Jia WX, Mao QX, Xiao XM, Li ZL, Yu RX, Li CR. Patchy alopecia areata sparing gray hairs: a case series. Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii. 2014;31(2):113. doi:10.5114/PDIA.2014.40956
13. Mohamad Aljabre SH (2005) Sparing of the upper axillary area in pityriasis versicolor. Rev Iberoam Micol 22(3): 167-168. doi: 10.1016/s1130-1406(05)70033-4
14. Byrd AL, Belkaid Y, Segre JA (2018) The human skin microbiome. Nat Rev Microbiol 16(3): 143-155. doi: 10.1038/NRMICRO.2017.157,
15. Staser K, Ezra N, Sheehan MP, Mousdicas N (2014) The beak sign: A clinical clue to airborne contact dermatitis. Dermatitis 25(2): 97-98. doi:10.1097/DER.0B013E3182A8ADA3.
16. Agarwal S, Khullar R, Kalla G, Malhotra YK (1992) Nose Sign of Exfoliative Dermatitis: A Possible Mechanism. Arch Dermatol 128(5): 704-704. doi:10.1001/ARCHDERM.1992.01680150138029
17. Mohapatra L, Samal K, Mohanty P, Dash S (2019) Reverse koebner phenomenon in bullous pemphigoid - A case report. Indian Dermatol Online J. 10(6): 692-694. doi:10.4103/idoj.IDOJ_512_18
18. Yadav S, De D, Kanwar A (2011) Reverse koebner phenomenon in leukocytoclastic vasculitis. Indian J Dermatol 56(5): 598. doi:10.4103/0019-5154.87169
19. Khan AS, Badar Q, Siddiqui K, Hanif S, Lakhan H (2024) Reverse Koebner Phenomenon in a Vitiligo Patient Treated With Radiotherapy. Cureus 16(5): 60771. doi:10.7759/CUREUS.60771
20. Sferopoulos NK (2016) Reverse Koebner Phenomenon Following Conservative Treatment of a Tibial Fracture. ARC Journal of Orthopedics 1(2): 24-26. doi:10.20431/2456-0588.0102004
21. Martín JM, Conde A, Pinazo I et al (2006) Reverse koebnerization after radiotherapy in a woman with a mastectomy for a breast carcinoma. J Am Acad Dermatol. 55(5 SUPPL.). doi:10.1016/J.JAAD.2004.03.042
22. Nasca MR, Micali G, Ferrau F (1995) Steroid acne sparing an area of previous irradiation [2]. Acta Derm Venereol 75(6): 495. doi:10.2340/0001555575495.
23. Mansur AT, Aydingöz IE (2009) Reverse isotopic response: A rarely reported phenomenon. Int J Dermatol 48(7): 783-784. doi: 10.1111/J.1365-4632.2009.04014.X.
24. Nemazee L, Harries M (2021) Frontal fibrosing alopecia sparing a vascular naevus: The Renbök phenomenon. Clin Exp Dermatol 46(4): 727-728. doi:10.1111/CED.14501.
25. Pakran J, Riyaz N (2011) Interesting effect of Malassezia spp. infection on dermatoses of other origins. Int J Dermatol 50(12): 1518-1521. doi:10.1111/J.1365-4632.2011.04945.X.
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CatM. T. C., NamT. N. K., & AnhM. B. H. (2025). Sparing phenomenon in dermatology: Case reports and literature review. Journal of 108 - Clinical Medicine and Phamarcy, 20(TA). https://doi.org/10.52389/ydls.v20iTA.2909