Deep circumscribed morphea: A case report

Bonnie Yudistha Anggawirya; Diah Mira Indramaya,; Putri Hendria Wardhani; Yuri Widia; Irmadita Citrashanty; Sawitri Sawitri; Iskandar Zulkarnain

No Detail Found!

Deep circumscribed morphea: A case report

Author(s)

Bonnie Yudistha Anggawirya Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

Diah Mira Indramaya, Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

Putri Hendria Wardhani Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

Yuri Widia Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

Irmadita Citrashanty Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

Sawitri Sawitri Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Iskandar Zulkarnain Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Abstract

Idiopathic sclerotic skin illnesses are included under the term "morphea", sometimes known as localized scleroderma. Deep induration of the skin and subcutaneous tissue that extends to the underlying muscle and bone is a feature of the morphea subtype known as "deeply circumscribed morphea. Improving the long-term result requires early diagnosis, accurate evaluation, and efficient therapy. We report a case of a 3-year-old boy with a 2-year history of multiple erythematous to violaceous plaques with subcutaneous atrophy on the buccal, oral, mental, and neck area. He has difficulty swallowing large pieces of food. A skin biopsy confirmed the diagnosis and showed the usual morphology of morphea. The patient was administrated tapered systemic corticosteroid for 20 weeks and oral Methotrexate course for 24 weeks. There was clinical improvement of the lesions clinically with decreased hyperpigmentation of the lesions, regression of the induration and no difficulty of swallowing. The patient is still being monitored to assess progression of the lesions and disease activity. Skin biopsy results and typical clinical symptoms are often used to diagnose morphea. Early diagnosis and treatment are required to reduce harm, such as aesthetic sequelae and functional impairment, that may be caused by uninterrupted exercise. Treatment depends on the depth of lesion involvement and the extent of the disease, focusing primarily on limiting disease activity. Morphea may be self-limited, but frequently has a remitting, relapsing or chronic course, resulting in significant disease burden over time.

Publication Details

Page(s) 582-586

DOI DOI not available

Published Journal: Journal of Pakistan Association of Dermatologists, Volume: 34, Issue: 2, Year: 2024

Request the full text from PASTIC

Keywords

Juvenile localized scleroderma, Deep circumscribed morphea, Morphea.

References

Eleftheriou D,Kinsler V,Yan A,Harper J,Oranje A,Bodemer C .2020 .Morphoea (Localized Scleroderma). Harper's Textbook of Pediatric Dermatology. 4th ed. New Jersey, : 1175-1128.

Weibel L,Sampaio MC,Visentin MT,Howell KJ,Woo P,Harper JI .2006 .Evaluation of methotrexate and corticosteroids for the treatment of localized scleroderma (morphoea) in children. Br J Dermatol, 155(5) : 1013-20.

Prasad S,Zhu JL,Schollaert-Fitch K,Torok KS,Jacobe HT .2021 .An Evaluation of the Performance of Current Morphea Subtype Classifications. JAMA Dermatol, 157(4) : 399-405.

Paller AS,Mancini AJ .2021 .. Collagen Vascular Disorder. In: Hurwitz Clinical Pediatric Dermatology, : 612-7.

Cyrus N,Jacobe H.,Morphea Lichen,Sclerosus Lichen,Amagai M,Bruckner A,Enk A,McMichael A,Orringer J .2019 .. Fitzpatrick's Dermatology, : 1107-16.

Aranegui B,Jiménez-Reyes J .2018 .. Morphea in Childhood: An Update. Actas Dermosifiliogr, 109(4) : 312-22.

Quispe SKJF,Cavaliere A,Weber M,Stramare R,Zuliani M,Quaia E .2020 .Sarcopenia in juvenile localized scleroderma: new insights on deep involvement. Eur Radiol, 30(7) : 4091-7.

Asano Y,Fujimoto M,Ishikawa O,Sato S,Jinnin M,Takehara K .2018 .Diagnostic criteria, severity classification and guidelines of localized scleroderma. J Dermatol, 45(7) : 755-80.

Melani L,Cardinali C,Giomi B,Schincaglia E,Caproni M,Fabbri P .2005 .Case study: Periodic Follow-Up Is Necessary in Morphea Profunda to Identify Systemic Evolution. Skinmed, 4(3) : 188-90.

Knobler R,Moinzadeh P,Hunzelmann N,Kreuter A,Cozzio A,Mouthon L .2017 .European Dermatology Forum S1-guideline on the diagnosis and treatment of sclerosing diseases of the skin, Part 1: localized scleroderma, systemic sclerosis and overlap syndromes. J Eur Acad Dermatol Venereol, 31(9) : 1401-24.

Browning JC. Pediatric,Morphea JC. Pediatric .2013 .. Dermatol Clin, 31(2) : 229-37.

Citations

Downloads

Views