Morphoea (localised scleroderma) in a patient with mixed connective tissue disease

An 18 year old girl concurrently developed skin lesions of morphoea (localised scleroderma) and pain and swelling of the hands and fingers. There were no dermatological or systemic signs of systemic sclerosis. The immunological features (high titred speckled antinuclear antibody, negative DNA binding, high titred positive anti-RNP and negative anti-Sm antibodies, speckled nuclear Ig fluorescence in the epidermis of the skin lesions) were consistent with mixed connective tissue disease, and it is suggested that the morphoea represented a component of this condition.