Wolf’s同位反应：细数带状疱疹的皮肤“后遗症”！

Wolf’s同位反应（Wolf’s Isotopic Response，WIR）即指在原发皮肤病痊愈后的原位置新发一种不相关疾病的现象，最初于1955年由Wolf等首次描述。带状疱疹是目前已报道文献中可诱发WIR的最常见原发病，故亦有作者建议将其命名为“Wolf’s带状疱疹后同位反应”（Wolf’s postherpetic isotopic response）。虽然病毒、血管、免疫、神经等因素均被考虑影响带状疱疹后WIR发生，但具体机制不详。为增进对带状疱疹后WIR继发病认知，现对相关文献进行简述。

1环状肉芽肿[1]

右侧T9区带状疱疹样环状肉芽肿

2嗜酸性皮炎[2]

真皮内嗜酸性粒细胞等炎症细胞浸润

3肉芽肿性皮炎[3]

4获得性反应性穿通性胶原病[4]

5浅表型基底细胞癌[5]（版主不认可该诊断）

该文献病例来自韩国，依据文中所展示病理图片，本人不认同其“浅表型基底细胞癌”诊断。

6肿胀型红斑狼疮[6]

7盘状红斑狼疮[7]

8银屑病[8]

9大疱性类天疱疮[9]

10带状疱疹后同位GVHD[10]

11硬化性苔藓[11]

a：右背部白色或黑色丘疹、斑片、紫癜；b，c：，毛囊角栓，表皮萎缩，真表皮分离，真皮浅层胶原均质化，附属器周炎症细胞浸润；d：CD117染色。

12粉刺[12]

13面部外部位的“面部肉芽肿”[13]

14CMV感染[14]

15脓疱疮[15]

16玫瑰痤疮[16]

17结节病样组织反应[17]

该患者基础病为MDS，带状疱疹后继发结节病样组织反应。

18嗜酸性脓疱性毛囊炎[18]

19瘢痕疙瘩[19]

20硬斑病[20]

21发疹型蓝痣[21]

22结节性痒疹[22]

23扁平苔藓[23]

24发疹性黄瘤[24]

25离心性环状红斑[25]

26玫瑰糠疹母斑[26]

27多发性表皮样囊肿[27]

28肉芽肿性毛囊炎[28]

29丛状血管瘤[29]

30其他

平滑肌瘤[30]、皮肤白血病[31]、持久性发疹性斑状毛细血管扩张症[32]、纤维弹性溶解性丘疹[33]、线状IgA皮病[34]、原发性皮肤黏蛋白病[35]等。

参考文献

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[33] H Shawa, C Opene, J M Schulman, et al. Post-zoster fibroelastolytic papulosis: an example of Wolf isotopic response[J]. Dermatol Online J, 2023; 29(2).

[34] N Goksugur. Linear IgA dermatosis after herpes zoster; Wolf's isotopic response[J]. Int J Dermatol, 2008; 47(10): 1087.

[35] D Camacho, F Feltes, S Machán, et al. Primary cutaneous dermal mucinosis on herpes zoster scars[J]. Cutis, 2016; 98(1): E19-23.

（本文仅作为科普与学术交流，增进了解，引起重视，有相关临床症状者，建议及时就医！！！）