fibrosis or long-term sequelae. A recent review found that skin and subcutaneous fat loss was established at the early stages of localized scleroderma, and that many patients with shorter disease duration had severe damage, with rates remaining constant with longer follow-up. 2 Treatment is more effective during the early inflammatory stage and halts further disease progression, thus early recognition and intervention is vital, 3 because once fibrotic change is established it is not reversible. Our patient responded rapidly to intravenous methylprednisolone, with MTX for maintenance treatment. Subcutaneous MTX is recommended by the Childhood Arthritis and Rheumatology Research Alliance (CARRA); however, our patient tolerated and responded well to oral MTX. 4 She required a shorter duration of treatment with MTX than described in the literature, 5 probably due to the prompt introduction of therapy before any evidence of sclerosis.In conclusion, we present an early presentation of en coup de sabre morphoea. This case highlights the importance of early diagnosis and intervention in preventing long-term sequelae.