Does solitary morphoea profunda progress?

Abstract

Solitary morphoea profunda (SMP) is an unusual form of scleroderma and is rarely mentioned in the literature. The back of the trunk is described as the commonest site of involvement by SMP. This disease has been recognized as a nonprogressive condition. We report three cases of SMP seen at our department within a 1-year period. Interestingly, all three patients were females and the lesions were situated on the right upper buttock. In one patient the lesion extended despite using topical tacrolimus but subsequently the lesion was kept under control with topical clobetasol propionate.

Primary Atrophic Solitary Morphea Profunda

“…SMP, a condition first described by Whittaker et al in 1989 [4], is extremely rare [4,5,6,7,8,9]. Patients with SMP are usually middle-aged with an approximately equal sex distribution.…”

“…In the latter case, penicillin [5], topical tacrolimus [9], local steroid injections [8], excision and skin grafting [7] have been tried with variable and inconsistent results. In our case, superpotent topical steroids had little effect.…”

“…Considering the possibility of the systemic evolution of morphea profunda [3, 9] periodic follow-up of patients is warranted.…”

“…Patients with SMP are usually middle-aged with an approximately equal sex distribution. Affected patients often exhibit a single plaque, most commonly located over the back, shoulder and neck or paraspinal area, involving the skin and deeper tissue [9]. …”

Scleroderma Mimickers

“…The cutaneous lesions are circumscribed with an ill-defined active erythematous or violaceous border, and a hypopigmented fibrotic center (10). The solitary plaque of morphea profunda typically occurs in a paraspinal location on the upper trunk (74). In the more generalized form, there is symmetric homogenous distribution over large surface areas, with involvement of the trunk and proximal extremities.…”