Deep circumscribed morphea: A case report

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.