Bullous morphea: a blistering sclerotic disease

Bullous morphea is a rare variant of localised scleroderma characterised by skin thickening and blister development. The following case report describes a woman in her 60s diagnosed with bullous morphea. The patient initially presented with a shiny, pruritic rash that spread from her back to her legs. The rash progressed to include fluid-filled bullae. A skin biopsy revealed thickened collagen bundles and epidermal lifting. Differential diagnoses included generalised morphea and lichen sclerosis, but clinical and histopathological findings supported the diagnosis of bullous morphea. The patient was treated with methotrexate, ultraviolet A phototherapy and physical therapy, which halted the progression of her skin thickening. This case highlights the importance of recognising bullous morphea as a unique clinical entity.