Congenital Skin Lesions Presenting as Morphea in a 4‐year‐old

Abstract

A 4-year-old boy with five asymptomatic, shiny plaques on his abdomen and chest, present since birth, was brought by his parents. He was born at term by normal vaginal delivery. There was no history of difficult or prolonged labor or use of forceps during delivery. The antenatal period was uneventful. He had no history of drug intake other than hematinics and calcium tablets taken by his mother during pregnancy. There was no history of similar lesions in the family. The parents were told that the lesions were birthmarks and these had been treated with emollients alone. The lesions increased in size proportionate to the growth of the child.His general physical and systemic examinations were within normal limits. Cutaneous examination revealed five, 3 × 4 to 8 × 6 cm ill defined, indurated plaques on the left half of the abdomen and chest (Fig. 1). The overlying skin was shiny, atrophic and could not be pinched. The skin over the periphery of the lesions was darker than the normal skin. There was no erythema in and around the lesions. A clinical diagnosis of morphea was made. Routine baseline investigations (complete blood cell count, ESR, clinical chemistries, and urinalysis) were normal. Serology for antinuclear antibodies, Borrelia burgdorferi , and TORCH (toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex) titers were negative in both the mother and the child.

Congenital morphea profunda in a 7-year-old male patient with coexistence of fibrous hamartoma of infancy: a rare case report

“…This study also reported a delay in diagnosis of up to 4 years [13]. Joshi et al reported the first case of biopsy-confirmed congenital plaque morphea in a 4-year-old boy on the abdomen since birth [14]. A similar case was described by Castanon et al in a 6-month-old girl [15].…”

Delay in Diagnosis of Congenital Linear Scleroderma until Adulthood

“…Joshi and colleagues reported the first case of biopsy-confirmed congenital morphea in a 4-year-old boy with plaques of morphea on the abdomen since birth. 7 Zulian and colleagues later described the clinical and serologic features of six children with congenital localized scleroderma, all linear type, including four with en coup de sabre subtype. 8 This study also reported a delay in diagnosis of up to 4 years, likely due to the rarity and lack of awareness of the condition.…”