A 77-year-old female presented to the rheumatology clinic for evaluation of an expansive, tightened skin plaque (Figure 1). The changes began 1 week after receiving the Moderna COVID-19 vaccination; otherwise, she had no changes in medications or lifestyle. Six months prior to her presentation, she went to her dermatologist who performed a biopsy with histologic findings suggestive of morphea (Figure 2). Initially, systemic treatment with mycophenolate was offered, but she declined at the time. Unfortunately, over the next 6 months, the lesion expanded across the trunk and back, becoming pruritic and thickened. Because of disease progression, she presented to rheumatology for further evaluation and treatment.