Sir,
We thank the authors for taking interest in our recent article titled, “Lichen planus pemphigoides presenting preferentially over preexisting scars: A rare instance of isotopic phenomenon.”[1] We, in our report, have etiologically related the development of lichen planus pemphigoides lesions to preexisting scars, to the sluggish circulation on account of scarring.
The authors have mentioned that our case is an example of immunocompromised cutaneous district. Events such as infections, trauma, and vaccinations in a particular site lead to immune dysregulation. After the primary event has subsided, the local interplay of immunological mediators becomes different from the surrounding skin. This possibly leads to the development of secondary complications including neoplastic, immunological, and infectious disorders.[2,3] In our case, the primary event was pyoderma gangrenosum which had healed with atrophic scars. In due course of the disease, as proposed by the authors, destabilization of immunological mediators and neurotransmitters took place. This dysregulation led to the development of lesions of lichen planus pemphigoides. Hence, this case can be definitely regarded as an example of “isoscartopic response.”
We would like to appreciate the authors for bringing out a new angle to our case report.[1]
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
- 1.Kumar P, Savant SS, Das A, Hassan S, Barman PD. Lichen planus pemphigoides presenting preferentially over preexisting scars: A rare instance of isotopic phenomenon. Indian J Dermatol. 2015;60:596–9. doi: 10.4103/0019-5154.169133. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Ruocco V, Brunetti G, Puca RV, Ruocco E. The immunocompromised district: A unifying concept for lymphoedematous, herpes-infected and otherwise damaged sites. J Eur Acad Dermatol Venereol. 2009;23:1364–73. doi: 10.1111/j.1468-3083.2009.03345.x. [DOI] [PubMed] [Google Scholar]
- 3.Lo Schiavo A, Brancaccio G, Romano F, Caccavale S. Nerve injury and localized skin lesions: An instance of immunocompromised district. Skinmed. 2012;10:260–1. [PubMed] [Google Scholar]
