GENERALIZED MORPHEA: CASE REPORT AND TREATMENT APPROACH
Keywords:
Morphea, Phototherapy, Pediatric Dermatology, InflammationAbstract
Morphea, also known as localized scleroderma, is a rare autoimmune disorder characterized by excessive collagen deposition, leading to fibrosis of the skin. Unlike systemic scleroderma, morphea does not affect internal organs but can cause significant morbidity due to skin hardening and potential involvement of underlying tissues such as muscles and joints.
An 11-year-old female patient was hospitalized for the first time at the Dermatology Clinic due to hyperpigmented skin lesions. According to the heteroanamnesis provided by her father, the lesions initially appeared on her thighs approximately one year ago, with an estimated size of around 20 cm. She was treated on an outpatient basis by a dermatologist, though no details on the therapy were provided. One month prior to hospitalization, the lesions worsened, expanding to the lower legs, chest, and upper extremities, accompanied by itching. Dermatological assessment revealed erythematous-livid, slightly indurated patches with a shiny, smooth surface. The lesion demonstrated areas of coalescing hyperpigmentation and hypopigmentation, distributed across the chest, abdomen and extremities. A skin biopsy was performed and confirmed early inflammatory-stage morphea.
Phototherapy, particularly UVA is an effective treatment for early-stage and inflammatory morphea, helping to reduce fibrosis, restore skin flexibility, and improve pigmentation. When combined with immunosuppressive agents, it enhances clinical outcomes and slows disease progression. Early intervention, guided by a multidisciplinary team, leads to a favorable prognosis, though long-term follow-up is essential to monitor recurrence and optimize management.
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