medigraphic.com
Colegio de Medicina Interna de México.

2022, Number 3

<< Back Next >>

Med Int Mex 2022; 38 (3)

Morphea profunda: A case report of an uncommon condition

Escandón-Pérez S, Landeta-Sa AP, Juárez-Duran ER, Vega-Memije ME, Arenas-Guzmán R

Language: Spanish
References: 22
Page: 701-707
PDF size: 229.23 Kb.


ABSTRACT

Background: Morphea is a rare chronic disease of the connective tissue, it is characterized by an increased production of collagen. This condition is usually limited to structures derivate from the mesoderm and is associated with other connective tissue disorders. Deep morphea is usually confirmed by biopsy and currently, there is no standardized treatment.
Clinical case: A 68-year-old male patient with a localized atrophic sclerodermiform plaque on the left scapular region, with poorly defined borders. Diagnosis was confirmed by biopsy and treatment was successful with methotrexate and prednisone.
Conclusions: This variety of morphea is a rare condition and is therefore poorly recognized; however, it must be timely detected, since the patient’s sequelae can affect him physically and emotionally. The approach to this disease must be multifactorial, without forgetting the psychological consequences that it can cause.


REFERENCES

  1. Strickler A, Gallo S, Jaramillo P, de Toro G. Morfea o eslcerodermialocalizada juvenil, caso clínico. Rev Chilena Pediatr 2016; 87 (4): 279-83. DOI: 10.1016/j.rchipe.2016.01.013

  2. Fernández-Rodríguez AM, Gandia Martínez M, Navas GarcíaN. Morfea generalizada unilateral: un caso y revisiónde la literatura. Reumatol Clin 2011; 7 (6): 404-6. DOI:10.1016/j.reuma.2011.01.004.

  3. Moreno-Ajona D, Moreno-Artero E, García de EulateMR, Irimia P, España A. Facial solitary morphea profundapresenting with painful trigeminal neuropathy:A case report. Cephalalgia 2019; 39 (4): 564-8. doi:10.1177/0333102418801580.

  4. Wlodek C, Korendowych E, McHugh N, Lovell CR. Morphoeaprofunda and its relationship to eosinophilic fasciitis.Clin Exp Dermatol 2018; 43 (3): 306-10. doi: 10.1111/ced.13353.

  5. Gaviria CM, Jiménez SB, Gutiérrez J. Morfea o esclerodermialocalizada. Rev Asoc Colomb Dermatología 2014; 22(2): 126-40.

  6. Aranegui B, Jiménez J. Morphea in childhood: An update.Actas Dermosifiliogr 2017; 109 (4): 312-22. doi: 10.1016/j.ad.2017.06.021.

  7. Fett N, Werth VP. Update on morphea: Part I. Epidemiology,clinical presentation, and pathogenesis. J Am Acad Dermatol2011; 64 (0): 217-28. doi: 10.1016/j.jaad.2010.05.045.

  8. Ohata C, Yasunaga M, Tsuruta D, Ishii N, Hamada T, Dainichi T,et al. Nodular morphea (NM): Report of a case of concurrentNM and morphea profunda associated with limited typesystemic sclerosis, and overview and definition for NM. Eur JDermatology 2013; 23 (1): 87-93. doi: 10.1684/ejd.2012.1893.

  9. Florez-Pollack S, Kunzler E, Jacobe HT. Morphea: Currentconcepts of skin and systemic manifestations. Clin Dermatol2018; 36 (4): 475-86. doi: 10.1016/j.clindermatol.2018.04.005.

  10. Rebollo N, Vega ME, Villaseñor P, García M. Mayor histocompatibilitycomplex class II (HLA-DR) is associated withmorphea and systemic sclerosis patients. Asia-Pacific JBlood Types Genes 2018; 2 (3): 165-70. DOI:10.46701/APJBG.2018032018124.

  11. Rebollo N, Gutiérrez D, Fonte V, Vega E. Morfea, una revisión.DCMQ 2007; 5 (4): 224-33.

  12. Touloei K, Wiener A, Glick BP. Solitary morphea profundafollowing trauma sustained in an automobile accident.Cutis 2015; 95 (1): 32-6.

  13. Ogawa T, Okiyama N, Takamuki R, Inoue S, Saito A, NakamuraY, Ishitsuka Y, Watanabe R, Fujisawa Y, Fujimoto M.Juvenile case of multiple morphea profunda resulting injoint contracture that was successfully treated with cyclosporinA: A case report and review of the published works.J Dermatol 2019; 46 (4): 354-357. doi: 10.1111/1346-8138.14801.

  14. Gutierrez D, Peterson EL, Kim RH, Franks Jr AG, I Lo SiccoK. Eosinophilic fasciitis with concomitant morpheaprofunda treated with intravenous immunoglobulin.Clin Rheumatol 2021; 27 (8S): S500-S501. doi: 10.1097/RHU.0000000000001158.

  15. Budamakuntla L, Malvankar D. Extensive morphea profundawith autoantibodies and benign tumors: a rare casereport. Indian Dermatol Online J 2012; 3 (3): 208-10. doi:10.4103/2229-5178.101823.

  16. Hsieh M, Shown-Tokoro S, Ugajin T, Takeshi-Namiki T, MiuraK, Yokozeki H. Ultrasonography as an auxiliary diagnostictool for morphea profunda: A case report. J Dermatol 2019;46 (7): 626-630. doi: 10.1111/1346-8138.14922.

  17. Onajin O, Wieland CN, Peters MS, Lohse CM, Lehman JS.Clinicopathologic and immunophenotypic features of eosinophilicfasciitis and morphea profunda: A comparativestudy of 27 cases. J Am Acad Dermatol 2018; 78 (1): 121-128. doi: 10.1016/j.jaad.2017.06.148.

  18. Rodríguez-Salgado P, García-Romero MT. Morfea: revisiónpráctica de su diagnóstico, clasificación y tratamiento.Gac Med Mex 2019; 155 (0): 522-31. DOI: 10.24875/GMM.18004288

  19. Bielsa I. Actualización en la clasificación y el tratamientode la esclerodermia localizada. Actas Dermosifiliogr 2013;104 (8): 654-66. DOI: 10.1016/j.ad.2012.10.003.

  20. Fett N, Werth VP. Update on morphea: Part II. Outcomemeasures and treatment. J Am Acad Dermatol 2011; 64(0): 231-42. doi: 10.1016/j.jaad.2010.05.046.

  21. De la Fuente-Laso P, González-García J, Castaño-Rivero A,Gonzalvo-Rodríguez P, Rodríguez-Díaz E, Vázquez-OsorioI. Morfea profunda solitaria. Una forma infrecuente deesclerodermia localizada en la infancia. Caso clínico. ArchArgent Pediatr 2019; 117 (2): e137-e141.

  22. Adeeb F, Anjum S, Hodnett P, Kashif A, Brady M, MorrisseyS, Devlin J, Duncan-Fraser A. Early- and late-stage morpheasubtypes with deep tissue involvement is treatable withabatacept (Orencia). Semin Arthritis Rheum 2017; 46 (6):775-781. doi: 10.1016/j.semarthrit.2016.08.018.




2020     |     www.medigraphic.com