The physician performed a 4-mm punch biopsy that confirmed the clinical suspicion of morphea (localized scleroderma).
Treatment options include high-potency topical glucocorticoids and topical calcipotriol (topical vitamin D). Localized scleroderma appears to soften with ultraviolet-A light therapy. Antihistamines and oral doxepin may be used to treat pruritus.
In this case, the patient was treated with topical clobetasol; she experienced some improvement in skin quality and symptoms. An antinuclear antibody test was positive, but she had not developed progressive systemic sclerosis.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Mayeaux EJ. Scleroderma and morphea. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill;2009:778-783.
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