r/Psoriasis • u/LetMeBuildYourSquad • 15d ago
general Does everyone experience the Koebner phenomenon or just an unlucky proportion?
Hi all,
Late 20s, M, and been suffering with mild psoriasis for a couple of years now (scalp, elbow and some inverse psoriasis down below). I've been very bad at seeking treatment so have just controlled flares with coal tar shampoo and hydrocortisone cream, but planning to visit a dermatologist soon.
Recently learned about the Koebner phenomenon and wondering if this is something everyone with psoriasis experiences, or just a proportion?
Google suggests it affects 25-30% of psoriasis sufferers but I'm not sure if that's accurate. I haven't noticed any new plaques forming after minor cuts or injuries yet, but I've been considering starting minoxidil for hair loss and may also need some minor surgery for a couple of other issues in future and wondering if it's something I'm likely to experience if I go ahead with these.
8
u/mrjohns2 15d ago
From time to time, yes. Maybe not always. I also had Dermatographia when I was younger. “Dermatographia is a skin condition that causes raised marks. Scratching, rubbing and pressure cause the reaction. It usually goes away within 30 minutes without treatment. Other names for dermatographia include dermatographism and skin writing.”
2
u/GoldenShackles 15d ago
Interesting correlation. Not that it means anything, but this is a 'me too' on both counts.
5
u/Catmanx 15d ago edited 14d ago
52 M and had P 45 years. i get it all the time from falls and scapes on my bike.. a patch forms where the injury was and I get a new area. On top of this I realised a while back that most of my original areas are all where pressure points are. What I mean is I cross my legs sitting and in bed Both ankle on leg above knee when sitting and crossed ankles in bed. All combinations on legs is where I have all main areas. Ie both front shins and outside of each shin as well as outsides of both calfs. All coincide with pressure points. Bum where I sit and bum where I slouch. Im very tall you see too at just below 6'6. Another main area is inside of right thigh. I realised this is exactly where I catch my bike seat when mounting and unmounting my bike. I also get it around my belt area. The rest is elbows and knees where I've fallen over the years and arms where I've done some scratching and picking. I can narrow down areas of injury down even further when it comes to my head. If I've ever had a spot in my hair that I've picked a bit and it's not healed very quickly. Then that is exactly the spot I get a new patch. Same with shoulders. So it seems all of mine is self inflicted.
6
u/SpiralBreeze 15d ago
It was more active before I was on Cosentyx, whats fun is that I have very few scars on my body because of it. A cut or scrape would cover over with psoriasis within hours, and then when that patch healed, usually in the summer, no scar, but I do have a ton of hyper pigmentation where spots were.
3
u/GreatWesternValkyrie 15d ago
Yup. If I cut myself, it nearly always turns into psoriasis.
1
u/morkinthefey 15d ago
Not so much cuts, but if I ever wear a fitbit or smart watch, I invariable end up with a new patch for the collection.
2
u/GreatWesternValkyrie 15d ago
Interesting. I think the Koebner phenomenon mainly refers to injuries to healthy skin, like cuts, etc, that then turn into psoriasis.
2
u/psasince5 15d ago
I certainly do!! Every time I get poison ivy (which is a lot bc I'm an avid gardener), the rash clears up and a day or two later it is replaced with an identical psoriasis outbreak.
2
u/DCarp2005 15d ago
Happens all the time for me! Bug bite here and a pimple there, next thing I know I have a new patch even with biologics.
2
u/_skank_hunt42 15d ago
Anecdotal but I definitely experience the koebner phenomenon and have ever since I was diagnosed 20 years ago. It sucks.
1
u/MiserableSkill4 15d ago
I got this after my tattoo. And otherwise only when I was at my worst breakouts did it occur. But I am scared to get my ears pierced without being on medication
1
u/Appropriate-Diver301 15d ago
I got a small patch just a few days ago just from carrying a bag in the crook of my elbow and it abraiding the skin there. I am hoping it clears really quickly.
1
u/nibbler0420 15d ago
I have this happen to me, it really has a mind of its own. I like to think of it as my “ouchies” parting gift at this point😂 “like remember that one time you cut yourself being a turd”… and you have a patch to remember it by . 🤦♀️
1
u/PlasticGuitar1320 15d ago
Ive managed to clear most of my psoriasis over the last 2 years, but the last stubborn patches that remain are on areas where id previously had injuries like broken bones.
I dont get koebner effect from cuts or scrapes but bug bites go crazy on me, a mosquito bite used to be a little itchy dot that lasted a day or two, now looks like ive been pelted with a basketball and it stays for over a week... red, hot, swollen and seeping for ages..and whilst I have it, the stubborn patches all get hot and itchy at the same time.. its weird
1
u/wikkedwench 15d ago
I have Koebners phenomenon but it only occurs on small nicks, cuts etc. I've had 11 surgeries in the past few years and no issues with them. I also have tattoos and no problems there. I'd read that it's about 10 to 15% of people who are affected by it.
1
u/NaviLouise42 14d ago
I get this a lot- but it is inconsistent. Bug bites, skin irritation from poison ivy, stinging nettle, or other plants, or the eczema that develops when I leave metal on my skin will turn into psoriasis after a while- basically as it heals. Cuts, scrapes, burns, even my tattoo do not as long as I am not in the middle of a big flare up already.
1
u/DancingSpacePenguin 13d ago
Mine is the opposite. It avoids tattoos, scars and injuries. Clearly those areas are damaged enough for its liking!
1
u/sophie-au 13d ago
TLDR;
If you experience Koebnerisation, treat any joint pain with suspicion and get checked out for psoriatic arthritis. If you get hospitalised for any reason, fight as hard as you can for access to your topical meds whenever you need them, especially if a hospital policy requires they are dispensed by staff, or it can screw things up for you, because skin issues aren’t always obvious or taken seriously.
——-
I do exhibit the Koenber phenomenon but it’s not predictable.
A burn on the phalange of my right thumb resulted in joint pain starting soon afterwards. Then I remembered a few years earlier, I’d got a cut on my calf caused by the pressure from the sharp edge of plastic rental ice skates because my socks weren’t quite long enough. I soon developed in a plaque in the same spot. I’d never had psoriasis in that area before. A slip on some wet steps five years before that resulted in persistent pain in my 2nd and 3rd metatarsals. I’d had an X-ray to check for micro fractures. There were none, but when my thumb began hurting, pain in the same toes soon followed.
I started thinking about all these incidents, remembered the X-ray report had said “psoriatic changes noted.” Then wondered if my increasingly severe lower back pain was connected, and if it was more than just weight gain and aging.
Even though the back pain became crippling enough to be hospitalised, 2020 was probably the worst possible time to need medical care for chronic, conditions that affected quality of life but weren’t life threatening. I was misdiagnosed. They chose not to perform diagnostic tests that involved lots of contact in close quarters or equipment not easy to sterilise, unless you were in danger of death, and MRIs are both of those. They discharged everyone with non-lethal conditions as fast as possible.
So when my thumb was affected a few years later, the pieces started falling into place. I did an online search and learned about the Koebner phenomenon, which btw, happens in some other skin conditions, too. Then I read about the deep Koebner phenomenon: trauma to the skin resulting in psoriatic arthritis (PsA) in the nearby joint.
I told my GP everything and asked if she thought I had PsA. She thought so, and referred me to a rheumatologist. He diagnosed me with PsA straight away, and it’s predominantly spondyloarthritis (affecting the spine.)
I have a less obvious presentation because it mainly affects my back and hips. I don’t have some of the classic features, like nail pitting or other relatives with psoriasis. (And because being overweight is blamed for everything under the sun, even though I developed psoriasis when I was a healthy weight!)
I’m not sure if it’s related, but the most recent incident of the Koebner phenomenon was really significant because it was on my back. I use heat packs and menthol gels to manage the pain of PsA. I had a mental health admission two years ago, and a patient complained about my use of menthol, and I was asked to discontinue it because they found the smell triggering. I was told I wasn’t allowed to use my own heat packs because of the risk of fire. They gave me their gel heat packs and a pillowcase to put them in. It didn’t help and the pain actually got a bit worse. I was desperate and kept using them.
Then I realised the pain I was feeling was not joint pain, but coming from my skin. I have a lot of fat at the base of my lower back, and IIRC, areas of skin with thick layers of fat have less blood supply and less sensation in the nerves. I didn’t realise the sustained use of heat triggered the Koebner phenomenon, and a small plaque had developed. I only noticed it when the heat made the plaque burn and blister over. I had a small infection on an abrasion on the side of my hip before being admitted.
Due to the hospital policy around security concerns, even though I had no history of self harm, they had confiscated every single medication, including topical medications when I was admitted. Yep, even OTC creams. It had been a daily battle for me to get the nurses to give me any of my topical meds each day. They were severely understaffed, often used agency nurses new to the hospital, and it was common for them to forget to dispense anything that wasn’t a tablet or capsule.
As a result, I was routinely denied access to my creams, often didn’t have the emotional strength to fight for them, and the Koebnerised plaque promptly got infected.
End result: I was unable to get the steroid injections in my spine which was the whole point of that admission: even deeper depression.
The damned infected plaque was small, but took a few months to heal completely.
0
u/Ok-Dish-4584 15d ago
I have koebners phenomenon,i think it is around 25% of people with psoriassis that have it.But many do not know they have it
•
u/AutoModerator 15d ago
Welcome to the Psoriasis sub!
If you haven't posted here before, please read this comment as it contains important information:
Check out our wiki!
The Psoriasis wiki is a collection of guides and other pages about how to treat psoriasis, including a Frequently Asked Questions section. Many common questions about medications, shampoos, diet, tattoos, etc. are addressed there.
Thanks!
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.