Deep circumscribed morphea: A case report

Authors

  • 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

Keywords:

Deep circumscribed morphea, juvenile localized scleroderma, morphea

Abstract

Introduction: Morphea or localized scleroderma, encompasses a group of idiopathic sclerotic skin diseases. Deep circumscribed morphea is one of morphea subtype with deep induration of the skin and subcutaneous tissue extending to the underlying muscle and bone. Early diagnosis, appropriate assessment and effective treatment are crucial to improve the long-term outcome.  Case: 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 of swallowing large pieces of food. The diagnosis was confirmed by skin biopsy, which revealed the typical 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 followed to assess progression of the lesions and disease activity. Discussion: The diagnosis of morphea is often based on characteristic clinical findings and skin biopsy. Early diagnosis and treatment are necessary to minimize damage such as cosmetic sequelae and functional impairment that may result from unabated activity. Treatment depends on the depth of lesion involvement and the extent of the disease, focuses primarily on limiting disease activity. Conclusion: Morphea may be self-limited, but frequently has a remitting, relapsing or chronic course, resulting in significant disease burden over time.  

References

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Published

2024-04-21

How to Cite

1.
Bonnie Yudistha Anggawirya, Indramaya DM, Wardhani PH, Widia Y, Citrashanty I, Sawitri S, Zulkarnain I. Deep circumscribed morphea: A case report. J Pak Assoc Dermatol [Internet]. 2024Apr.21 [cited 2024May22];34(2):582-6. Available from: https://jpad.com.pk/index.php/jpad/article/view/2522

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