Abstract
Background
 Wolf’s isotopic response has been described in association with malignancy, infections, and inflammatory disorders. Lichenoid tissue reactions are a rare but recognized example of this phenomenon; only 41 cases of zosteriform lichen planus exist in publication. This case adds to the minimal literature describing lichenoid inflammatory dermatosis compatible with Wolf’s isotopic response.
 
 Methods
 Literature review and case description.
 
 Results
 A man in his 30s with a history of herpes zoster presented with a pruritic rash on his left arm. Clinical and histopathological evaluation were consistent with lichen planus in the distribution of a healed herpes zoster rash. The skin lesions improved after six weeks of treatment with clobetasol 0.05% ointment twice daily.
 
 Conclusions
 The presentation of lichen planus as Wolf’s isotopic response is uncommon, but responsive to standard topical therapy.
Highlights
Wolf’s isotopic response is the occurrence of a new skin disorder at the site of another unrelated and already healed skin disease.[1]
Subsequent studies have confirmed a predilection for epidermal carcinomas to develop in skin previously affected by herpes viruses.[3]
A man in his 30s presented with a twomonth history of a pruritic eruption on his left arm. He reported pain at the onset of the eruption, but otherwise denied fever, chills, diaphoresis, nausea, or weight loss. His medical history was significant for metastatic oropharyngeal squamous cell carcinoma previously treated with chemotherapy and radiation, currently undergoing pembrolizumab immunotherapy
Summary
A man in his 30s with a history of herpes zoster presented with a pruritic rash on his left arm. The skin lesions improved after six weeks of treatment with clobetasol 0.05% ointment twice daily
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