Pansclerotic Morphea, Refractory to Multiple Systemic Therapies, Successfully Treated with UVA-1 Phototherapy

Pansclerotic morphea is a rare and debilitating variant of localized scleroderma characterized by extensive skin sclerosis. Conventional therapies may be ineffective, particularly in patients with comorbidities that limit treatment options, prompting the need for alternative modalities.

A 29-year-old African American male with autoimmune hepatitis presented with progressive sclerotic plaques on the trunk and extremities, accompanied by nonhealing leg ulcers. Biopsy and clinical findings confirmed pansclerotic morphea. Prior treatments, including topical and systemic corticosteroids, were unsuccessful, and methotrexate was contraindicated. Given the refractory nature of the disease, UVA-1 phototherapy was initiated as salvage therapy.

After 6 months of UVA-1 phototherapy, the patient showed marked clinical improvement, including softening of skin induration and complete wound healing, with no adverse effects. This case underscores the value of UVA-1 phototherapy as a safe and effective treatment for severe morphea, especially in patients unable to receive standard immunosuppressive therapies.