{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:51:53Z","timestamp":1753883513198,"version":"3.41.2"},"reference-count":10,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T00:00:00Z","timestamp":1669766400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Koebner phenomenon is an uncommon skin-related complication of subcutaneous insulin injection in patients with diabetes mellitus. This reaction, also referred as isomorphic phenomenon, has previously been described in various conditions including vitiligo, lichen planus, and psoriasis. We report a 56-year-old woman insulin-treated patient with type 2 diabetes mellitus who developed new-onset, sharply well-demarcated erythematous scaly plaques at the insulin injection sites consistent with Koebner phenomenon. These lesions occurred after withdrawal of methotrexate initiated for the treatment of psoriasis. The lesions responded well to guselkumab, an interleukin-23 targeting agent but not ciclosporin. Of note, unlike previously reported cases, our patient developed isomorphic response under treatment with insulin analogues and during psoriasis flare-up. This case highlights the paramount role of thorough and cautious examination of injection and insertion sites in patients at risk undergoing subcutaneous continuous glucose monitoring or treated with continuous transdermal\/subcutaneous insulin injections.<\/jats:p>","DOI":"10.1210\/jcemcr\/luac016","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T14:56:23Z","timestamp":1669820183000},"source":"Crossref","is-referenced-by-count":2,"title":["Isomorphic (Koebner) Phenomenon Induced by Insulin Analogue Injections in Psoriasis"],"prefix":"10.1210","volume":"1","author":[{"given":"Saartje","family":"Thijs","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, VITAZ Hospital , Sint-Niklaas , Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4445-308X","authenticated-orcid":false,"given":"Eric","family":"Balti","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, VITAZ Hospital , Sint-Niklaas , Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corinne","family":"Degraeve","sequence":"additional","affiliation":[{"name":"Molenstraat 160 Private Dermatology Clinic , Kruibeke , Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Coremans","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, VITAZ Hospital , Sint-Niklaas , Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"issue":"10","key":"2023100215454014100_luac016-B1","doi-asserted-by":"crossref","first-page":"661","DOI":"10.2165\/00128071-200304100-00001","article-title":"Skin-related complications of insulin therapy: epidemiology and emerging management strategies","volume":"4","author":"Richardson","year":"2003","journal-title":"Am J Clin Dermatol"},{"issue":"Suppl 1","key":"2023100215454014100_luac016-B2","doi-asserted-by":"crossref","first-page":"S46","DOI":"10.2337\/dc22-S004","article-title":"4. Comprehensive medical evaluation and assessment of comorbidities: Standards of Medical Care in Diabetes\u20142022","volume":"45","author":"American Diabetes Association Professional Practice Committee","year":"2022","journal-title":"Diabetes Care"},{"issue":"8","key":"2023100215454014100_luac016-B3","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1001\/jamadermatol.2015.6015","article-title":"Heinrich Koebner and his phenomenon","volume":"152","author":"Diani","year":"2016","journal-title":"JAMA Dermatol"},{"key":"2023100215454014100_luac016-B4","doi-asserted-by":"crossref","first-page":"m1590","DOI":"10.1136\/bmj.m1590","article-title":"National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study","volume":"369","author":"Parisi","year":"2020","journal-title":"BMJ"},{"issue":"4","key":"2023100215454014100_luac016-B5","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1111\/bjd.12473","article-title":"Psoriasis, psoriatic arthritis and type 2 diabetes mellitus: a systematic review and meta-analysis","volume":"169","author":"Coto-Segura","year":"2013","journal-title":"Br J Dermatol"},{"issue":"2","key":"2023100215454014100_luac016-B6","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1159\/000104261","article-title":"Experimental Koebner phenomenon in patients with psoriasis","volume":"215","author":"Kalayciyan","year":"2007","journal-title":"Dermatology"},{"issue":"1","key":"2023100215454014100_luac016-B7","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1002\/pdi.1994","article-title":"Vitiligo and lipohypertrophy surrounding insulin injection sites in a patient with type 1 diabetes","volume":"33","author":"Hedges","year":"2016","journal-title":"Pract Diabetes"},{"issue":"6","key":"2023100215454014100_luac016-B8","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.ad.2010.01.011","article-title":"Lichen sclerosus atrophicus at an insulin injection site: an unusual Koebner phenomenon [article in Spanish]","volume":"101","author":"Monteagudo","year":"2010","journal-title":"Actas Dermosifiliogr"},{"issue":"6","key":"2023100215454014100_luac016-B9","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.amjmed.2010.03.005","article-title":"Pokes, papules, plaques","volume":"123","author":"Federman","year":"2010","journal-title":"Am J Med"},{"issue":"5","key":"2023100215454014100_luac016-B10","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1684\/ejd.2011.1479","article-title":"Subcutaneous injection of isophane protamine biosynthetic human insulin induced psoriasis at the injection site","volume":"21","author":"Wang","year":"2011","journal-title":"Eur J Dermatol"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/advance-article-pdf\/doi\/10.1210\/jcemcr\/luac016\/47448682\/luac016.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/1\/1\/luac016\/51824883\/luac016.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/1\/1\/luac016\/51824883\/luac016.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T15:46:00Z","timestamp":1696261560000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luac016\/6854839"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,29]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,11,29]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luac016","relation":{},"ISSN":["2755-1520"],"issn-type":[{"type":"electronic","value":"2755-1520"}],"subject":[],"published-other":{"date-parts":[[2023,1,1]]},"published":{"date-parts":[[2022,11,29]]},"article-number":"luac016"}}