Plaque morphea with neurological involvement—an extraordinary uncommon presentation

Area of Science:

• Dermatology
• Neurology
• Autoimmune Diseases

Background:

• Localized scleroderma (LS) traditionally affects skin, subcutaneous tissue, and bone.
• Craniofacial LS subtypes are known to involve the nervous system.
• Systemic manifestations in LS are increasingly recognized but rare in non-craniofacial subtypes.

Observation:

• A rare case of localized scleroderma en plaque (morphea) on the upper trunk and neck is presented.
• The patient experienced neurological manifestations in the form of seizures.
• Brain MRI revealed focal lesions contralateral to the skin lesions.

Findings:

• This case demonstrates an unusual association between morphea and neurological symptoms.
• The findings suggest that localized scleroderma may stem from a systemic autoimmune process.
• Neurological involvement in LS, though rare, warrants further investigation.

Implications:

• This case underscores the importance of considering systemic autoimmune processes in localized scleroderma.
• It may prompt further research into the pathogenesis of localized scleroderma and its potential systemic effects.
• Highlights the need for comprehensive evaluation in patients with atypical localized scleroderma presentations.