Indian Journal of Dermatology
LETTER IN RESPONSE TO PREVIOUS PUBLICATION IN IJDŽ
Year
: 2017  |  Volume : 62  |  Issue : 1  |  Page : 93--94

Author's reply


Shrenik Balegar, Dharmendra Kumar Mishra, Sagarika Chatterjee, Shweta Kumari, Anup Kumar Tiwary 
 Department of Dermatology, Venereology and Leprosy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India

Correspondence Address:
Shrenik Balegar
Department of Dermatology, Venereology and Leprosy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand
India




How to cite this article:
Balegar S, Mishra DK, Chatterjee S, Kumari S, Tiwary AK. Author's reply.Indian J Dermatol 2017;62:93-94


How to cite this URL:
Balegar S, Mishra DK, Chatterjee S, Kumari S, Tiwary AK. Author's reply. Indian J Dermatol [serial online] 2017 [cited 2020 Oct 21 ];62:93-94
Available from: https://www.e-ijd.org/text.asp?2017/62/1/93/198045


Full Text

Sir,

I am delighted that authors have shown keen interest in the case report published in the journal.[1] Radiation in our case definitely caused alteration in the local immune response the so-called “immunocompromised cutaneous district,” which led to the development of morphea. The authors have thrown light on the mechanism, by which immune dysregulation occurs in the irradiated areas. Altered trafficking of immune competent cells, lymphatic obstruction, and interference in neurotransmitter signaling, all lead to immune disorders such as morphea. The term isotopic response first described by Wolf et al. [2] refers to occurrence of a new skin disorder at the site of another, unrelated, and already healed skin disease.[2] The localization of skin diseases remains one of the most elusive problems in dermatology.[2] Etiology of isotopic response is thought to be immunologic, neural, vascular, viral, and locus minoris resistentiae (a site of lessened resistance).[3] The concept of isoradiotopic response as described and categorized by Caccavale et al. [4] does hold good in our case. More literature review is needed to consider it a new form of isotopic response.

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Conflicts of interest

There are no conflicts of interest.

References

1Balegar S, Mishra DK, Chatterjee S, Kumari S, Tiwary AK. Generalized morphea following radiotherapy for an intracranial tumor. Indian J Dermatol 2016;61:581.
2Wolf R, Brenner S, Ruocco V, Filioli FG. Isotopic response. Int J Dermatol 1995;34:341-8.
3Thappa D. Isotopic response versus isomorphic response. Indian J Dermatol Venereol Leprol 2004;70:376.
4Caccavale S, Kannangara AP, Ruocco E. Categorization of and comments on isomorphic and isotopic skin reactions. Clin Dermatol DOI: 10.1016/j.clindermatol.2015.10.011. [In Press].