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Aida Khaled1, Monia Kharfi, Anissa Zaouek

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A child developed morphea profunda (MP) after diphtheria-tetanus-pertussis vaccination. Combined steroid and methotrexate therapy effectively treated the condition, leading to significant regression.

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Area of Science:

  • Pediatric Dermatology
  • Immunology
  • Dermatopathology

Background:

  • Morphea profunda (MP) is a rare, deep form of morphea.
  • Postvaccination morphea profunda is an uncommon presentation.
  • Understanding its etiology and treatment is crucial for pediatric patients.

Observation:

  • A 2-year-old girl presented with a 9-month history of thigh induration.
  • The lesion appeared 3 months after receiving the diphtheria-tetanus-pertussis vaccine.
  • Clinical examination revealed a 7x7 cm induration with an 'orange peel' texture.

Findings:

  • Histologic examination confirmed morphea profunda.
  • Initial treatment with systemic steroids stabilized the lesion.
  • Combination therapy with oral methotrexate led to significant regression without relapse.

Implications:

  • This case highlights a potential link between vaccination and morphea profunda in children.
  • Early and combination therapy may improve outcomes for postvaccination morphea profunda.
  • Further research is needed to elucidate the immunologic mechanisms involved.