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Generalized Morphea Coincident With Aplastic Anemia: A Case Report
Madhusudan R Tapdia1, T T Favas1, Vijaya Nath Mishra1
1Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND.
Abstract:
Morphea is a rare skin condition characterized by erythematous or violaceous lesions as well as sclerotic plaques. Patients with morphea frequently have other autoimmune disorders. Contributing factors are thought to be autoimmunity and an increase in extracellular matrix production. A case of a 45-year-old male patient with progressive restriction of both shoulder movements and patchy discoloration over the abdomen, neck, back, forearms, and bilateral axillae is discussed in this article. Examination revealed multiple shiny hyperpigmented to hypopigmented indurated plaques, and some lesions showed erythematous to violaceous borders, fine scales, and woody induration. The neurological examination was normal. Skin biopsy showed a sparse superficial perivascular lymphohistiocytic infiltrate with thickening of collagen bundles that were hyalinized in the reticular dermis, which was consistent with superficial morphea. Hematological tests showed pancytopenia and bone marrow aspiration revealed hypocellular marrow, which was consistent with aplastic anemia. The patient was diagnosed with generalized morphea with aplastic anemia. The patient was referred to a transplant center for further treatment, but, unfortunately, he died of sepsis while waiting for his transplant. Our case may indicate a possible link between aplastic anemia and generalized morphea. Due to a possible similar underlying mechanism of pathogenesis, treatment of aplastic anemia may be effective in morphea also. Aplastic anemia must be detected early to reduce complications and mortality in patients.
Insights
This case study highlights a rare instance of generalized morphea co-occurring with aplastic anemia in a 45-year-old male. Early detection of aplastic anemia is crucial for managing morphea patients.
Area of Science:
- Dermatology
- Hematology
- Immunology
Background:
- Morphea is a rare autoimmune skin condition causing sclerotic plaques.
- Autoimmunity and increased extracellular matrix production are suspected contributors.
- Patients with morphea often have co-existing autoimmune disorders.
Observation:
- A 45-year-old male presented with restricted shoulder movement and skin discoloration.
- Physical examination revealed indurated, hyperpigmented to hypopigmented plaques with erythematous borders.
- Skin biopsy confirmed superficial morphea, while hematological tests revealed pancytopenia and hypocellular bone marrow, indicative of aplastic anemia.
Findings:
- The patient was diagnosed with generalized morphea and aplastic anemia.
- A skin biopsy showed characteristic changes of superficial morphea.
- Hematological findings were consistent with aplastic anemia.
Implications:
- This case suggests a potential link between generalized morphea and aplastic anemia.
- Shared pathogenic mechanisms may exist, suggesting potential therapeutic overlaps.
- Early diagnosis of aplastic anemia is vital for improving outcomes in morphea patients.
