AA 6-year-old female child presented with shiny, well defined indurated atrophic plaque on the side of waist (Fig. 1) and extensive scarring and fibrosis of left knee and both feet (Fig. 2) for over 2 years. Lesions started 2 years back from both feet as red, shiny areas. Within a year, the child developed a limping gait and waist lesion appeared since the last 8 months. Skin biopsy from the waist lesion confirmed the diagnosis of morphea.

Figure 1. Morphea - plaque type

Fig 2. Morphea - linear type.

Morphea or circumscribed scleroderma are of 5 types-Guttate, plaque, linear, segmental and subcutaneous. Linear scleroderma mainly occurs in extremities and scalp where atrophy of subcutaneous fat and muscles results in contractures of muscles and tendons. In children, impaired growth of affected limb can occur. Plaque type causes round or oval well defined indurated shiny atrophic lesions. No specific therapy is known, physiotherapy is advised to prevent crippling deformities. Steroids are of benefit in early phaseof the disease.

Sumit Kar,
Pradeep Sahare*,
Department of Dermatology and Pediatrics*,
MGIMS, Sevagram,
District Wardha (MS) 442102,
India.