RESUMEN
INTRODUCTION: Morphea, or localized scleroderma, is an inflammatory disease that leads to sclerosis of the skin and underlying tissues due to excessive collagen deposition. Its etiology remains elusive. Morphea also affects oral and perioral tissues, the most common clinical manifestations being facial skin and tongue rigidity. Below, we present a case of morphea with oral manifestations. CASE PRESENTATION: A 17-year-old patient was referred to our department of oral surgery by her dermatologist for possible oral morphea involvement. She presented pigmented skin lesions involving the right labial-chin region. On palpation, the skin of her perioral was sclerotic. the panoramic radiograph showed a shortening of the roots of the 46/47 with a developmental delay of the 48 compared to the 38. A bone biopsy was performed between 46/47 and distal to 48. histological examination showed bone tissue with fibrous and collagenous reorganization in favor of scleroderma. CONCLUSION: The management of plaque morphea is multidisciplinary. The role of the dentist is very important to avoid any oral complications.
RESUMEN
The term plaque morphea describes a variant of morphea (localized scleroderma) in which oval or round circumscribed areas of induration, pigmentary changes, and violaceous or erythematous halo (i.e., lilac ring) are found in the dermis and occasionally to the superficial panniculus. We report a case of 28-year-old male patient with recurrent plaque morphea who was treated with polydioxanone (PDO) mono threads and topical tacrolimus ointment. After the introduction of PDO mono threads, the patient was prescribed topical tacrolimus ointment for six months. After that six-month period, the lesions were softer to palpation and lighter in color. This was observed as a positive therapeutic response. Notably, no future recurrence was seen at one-year follow up.
RESUMEN
Morphea profunda is a rare subtype of localized scleroderma and it is difficult to evaluate the conditions of sclerotic changes at an early stage. Studies using ultrasonography to evaluate localized scleroderma are limited and, to date, the characteristic findings of morphea profunda assessed by ultrasonography have never been reported. Here, we present a case of morphea profunda diagnosed with the assistance of ultrasonography. A 69-year-old Japanese woman with a past history of morphea en plaque on her lower abdomen presented with skin indurations of her bilateral lower back and thighs. To evaluate the stiffness of the subcutis, fascia and muscle, we utilized ultrasonography and found an unexpected hyperechogenicity not only of the dermis but also in the deeper tissue. The diagnosis was revised to morphea profunda after we performed a deep skin biopsy, including the muscle tissue. From this case, we assert that ultrasonography is a useful alternative tool to assist in the differential diagnosis of morphea profunda.