title: Linear morphea presenting as acquired unilateral edema.
abstract: We describe a 2-year-old African-American boy with a 4-month history of gradually worsening unilateral edema that was initially noted on his left hand and then approximately 2 weeks later on his left lower extremity. In addition, linear hypopigmented patches were noted along the left forearm and leg, with no appreciable scarring or induration. The edema on the left-hand side of his body progressed so that he developed tense bullae on his left hand. Two months later, the hypopigmented patches were indurated and bound-down, especially over the left groin and thigh. A biopsy specimen from this area showed features characteristic of morphea. In this patient, dilated lymphatic channels secondary to the sclerosis of the morphea caused the bullae. Bullous morphea is a rare condition. We were unable to find any reports its occurrence in children under 18 with associated lymphedema. This entity should be included in the differential for acquired unilateral edema in children.
authors.affiliation: Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
authors.forename: Katherine H
authors.initials: KH
authors.lastname: Fiala
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wells
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Mullinax
authors.forename: Cloyce L
authors.initials: CL
authors.lastname: Stetson
authors.forename: Brent R
authors.initials: BR
authors.lastname: Paulger
mesh_terms: D002675:Child, Preschool; D004487:Edema / Q000209:etiology*; D006801:Humans; D017496:Hypopigmentation / Q000209:etiology; D008297:Male; D012594:Scleroderma, Localized / Q000150:complications* / Q000473:pathology* / Q000628:therapy