title: Primary atrophic solitary morphea profunda.
abstract: Solitary morphea profunda (SMP) is a distinct form of localized scleroderma, a cutaneous disorder of unknown origin. Here, we describe a patient presenting with noninflammatory cupuliform depressed plaques, without any significant skin induration, pigmentation or texture change, that appeared on the left shoulder at a site of previous intramuscular vaccination. Light microscopy studies revealed excessive dermal collagen deposition with thickened hyalinized collagen bundles. Magnetic resonance imaging studies demonstrated tissue fibrosis with thinning of the subcutaneous fat tissue and involvement of the adjacent deltoid muscle, which was confirmed by electromyographic tests. Borrelia serology was negative. Our observation of SMP differed from previously described cases, since it mimicked localized lipoatrophy. Our observation highlights the wide spectrum of clinical presentations of localized scleroderma. The latter should be considered in the presence of lipoatrophy-like lesions for proper workup and therapy.
authors.affiliation: Clinic of Dermatology, University Hospital of Geneva, Geneva, Switzerland. elhem_khelifa@yahoo.com
authors.forename: Elhem
authors.initials: E
authors.lastname: Khelifa
authors.forename: Isabelle
authors.initials: I
authors.lastname: Masouyé
authors.forename: Pierre
authors.initials: P
authors.lastname: Chavaz
authors.forename: Herman
authors.initials: H
authors.lastname: Hauser
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Grillet
authors.forename: Luca
authors.initials: L
authors.lastname: Borradori
mesh_terms: D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012594:Scleroderma, Localized / Q000473:pathology*