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Research Letter
September 15, 2008

The Isomorphic Response in Morphealike Chronic Graft-vs-Host Disease

Arch Dermatol. 2008;144(9):1229-1231. doi:10.1001/archderm.144.9.1229

The isomorphic response of Koebner, also known as the Koebner phenomenon, is a well-recognized dermatologic manifestation first described in psoriasis. The isomorphic response occurs when a dermatologic disease develops at a site of normal-appearing skin that is injured in some manner.1

Chronic graft-vs-host disease (cGvHD) is a multisystem disorder that commonly affects the skin and may present with protean manifestations. Sclerotic cGvHD features are categorized as lichen sclerosus–like, morphealike, or sclerosis involving the subcutaneous tissue and fascia.2 Morphealike lesions of cGvHD are characterized by localized dyspigmented indurated plaques of skin thickening.

A retrospective analysis was performed of 110 consecutive patients with a diagnosis of cGvHD of any organ system evaluated in a cross-sectional cGvHD study at the National Institutes of Health (NIH).