clinical features

Last reviewed 05/2021

Presentation usually occurs in patients under 30 years of age as asymptomatic, round or oval, firm, smooth, reddish plaques, several centimetres in diameter, with a well marked red or violaceous border (1,2).

They may arise on any body site but are most common on the thighs, trunk and upper arms. Gradually, the centre of the lesion become atrophic and white, and the erythematous border is lost (2).

The plaques become very firm and calcification is not uncommon. "Burnt out" lesions may become hyperpigmented.

A linear variant is commonly seen on the scalp and may cause a scarring alopecia. It often extends to the forehead appearing as an exaggerated scar - "en coup de sabre". A furrow or a depression below the level of the surrounding skin can be seen (2). In young children, this may result in growth irregularities of the underlying skull.

Generalised cutaneous disease is rare. This is a severe form of morpheoa with an extensive involvement of the skin. Numerous indurated plaques, hyperpigmentation and frequent muscle atrophy is seen in this disease (2).

Reference:

• 1. Barankin B, Kossintseva I. Answer: Can you identify this condition? Can Fam Physician 2007; 53(10):1675 - 1676
• 2. Takehar K, Sato S. Localized scleroderma is an autoimmune disorder. Rheumatology 2005;44(3):274-279