Morphea of the eyelids

Area of Science:

• Dermatology
• Pathology
• Ophthalmology

Background:

• Morphea, a form of localized scleroderma, typically affects the trunk and extremities.
• Eyelid involvement in morphea is exceptionally rare, presenting unique diagnostic and management challenges.

Observation:

• A case of biopsy-proven morphea affecting both upper eyelids is presented.
• The patient exhibited clinical signs consistent with localized scleroderma of the eyelids.

Findings:

• Histopathology revealed epidermal thinning and dermal collagen fiber thickening and sclerosis.
• Key findings included decreased fibrocytes, entrapped eccrine sweat glands, and reduced pilosebaceous units.
• Moderate lymphocytic infiltration and prominent lymphocytic perivasculitis were observed in the dermis.

Implications:

• This report expands the understanding of morphea's clinical spectrum, highlighting its potential ocular adnexa manifestation.
• Comparing histopathologic features with lichen sclerosus et atrophicus aids in differential diagnosis.
• Further research is warranted to elucidate the pathogenesis and optimal treatment strategies for eyelid morphea.