Unilateral generalized morphea: First case report in Taiwan

Area of Science:

• Dermatology
• Paediatric Rheumatology
• Autoimmune Diseases

Background:

• Generalised morphea (GM) is a subtype of localized scleroderma, typically presenting with bilateral skin manifestations.
• Unilateral generalised morphea (UGM) is a rare, asymmetric variant of GM, posing unique clinical challenges.

Observation:

• A case of UGM in a Taiwanese girl affecting the left side of her body, including extremities and trunk.
• Clinical presentation included hyperpigmentation, skin tightness, atrophy, and mild range of motion limitation in the left knee.

Findings:

• The patient received a treatment regimen including oral prednisolone, methotrexate (MTX), and D-penicillamine, alongside topical emollients and glucocorticoids.
• Gradual tapering of oral prednisolone was implemented.
• Significant improvement in all symptoms was observed following the treatment and a consistent rehabilitation program.

Implications:

• This case report offers a potential treatment strategy for pediatric UGM, demonstrating efficacy without requiring intravenous methylprednisolone pulse therapy.
• Highlights the importance of a multidisciplinary approach involving medication and rehabilitation for managing UGM in children.
• Contributes to the limited evidence base for UGM treatment, particularly in the pediatric population.