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Morphoea (localised scleroderma) in a patient with mixed connective tissue disease
Annals of the Rheumatic Diseases
|June 1, 1986
Summary
A young woman developed localized scleroderma and hand inflammation, showing immunological markers for mixed connective tissue disease. Researchers suggest morphoea can be a manifestation of this systemic autoimmune condition.
Area of Science:
- Rheumatology
- Dermatology
- Immunology
Background:
- Mixed connective tissue disease (MCTD) is an autoimmune disorder characterized by overlapping features of systemic sclerosis, lupus erythematosus, and polymyositis.
- Morphoea, a localized form of scleroderma, typically presents as skin hardening and discoloration without systemic involvement.
Observation:
- An 18-year-old female presented with concurrent morphoea skin lesions and inflammatory arthritis affecting her hands and fingers.
- Clinical examination revealed no signs indicative of systemic sclerosis.
Findings:
- Immunological profiling demonstrated high-titred speckled antinuclear antibodies (ANA), positive anti-RNP antibodies, and negative anti-Sm antibodies.
- Speckled nuclear immunoglobulin G (IgG) fluorescence was observed in the epidermis of the morphoea lesions.
- These serological findings were consistent with the diagnostic criteria for mixed connective tissue disease.
Implications:
- The case suggests that morphoea can be a presenting or component feature of mixed connective tissue disease.
- This finding expands the understanding of the clinical spectrum of MCTD and its dermatological manifestations.
- Highlights the importance of comprehensive immunological evaluation in patients with morphoea presenting with systemic symptoms.