Pansclerotic morphea: A case report


  • Anum Sadia Fatima Jinnah Medical University
  • Anum Sadia Fatima Jinnah Medical University


Adult, Generalized pansclerotic morphea, steroid pulse therapy


Generalized disabling pansclerotic morphea is a rare and mutilating form of morphea involving the dermis, subcutaneous tissue, fat, muscle, and even bone. It most often occurs in young children but adults can also be affected. We report a case of rapidly progressing and disabling adult onset generalized pansclerotic morphea, which responded well to methotrexate and steroid pulse therapy.  


Singh A, Singhal K, Choudary S, Bisati S, Arora M. Adult onset unilateral disabling pansclerotic morphea. Indian J Dermato.l 2014 May-Jun; 59(3): 316

Padmavathy L, Rao LL. Unilateral linear pansclerotic morphea affecting face and limbs. Indian J Dermatol Venereol Leprol. 2005;71: 192–4. [PubMed] [Google Scholar]

Maragh SH, Davis MD, Bruce AJ, Nelson AM. Disabling pansclerotic morphea: clinical presentation in two adults. J Am Acad Dermatol. 2005 Aug; 53(2 Suppl 1):S115-9. doi: 10.1016/j.jaad.2004.10.881. PMID: 16021158.

Orteu CH. Morphea and Allied Scarring and Sclerosing Inflammatory Dermatoses. In: Griffiths CE, Barker J, Bleiker T, Chalmers R, Creamer D, editors. Rook's Textbook of Dermatology. 9th ed. Oxford: Wiley Blackwell; 2016. p. 1561.

Heck J, Olk J, Kneitz H, Hamm H, Goebeler M. Long-standing morphea and the risk of squamous cell carcinoma of the skin. J Dtsch Dermatol Ges. 2020 July; 18(7): 669-673

Bielsa I, Ariza A. Deep morphea. Semin Cutan Med Surg. 2007 Jun;26(2):90 –95. [PubMed] [Google Scholar]

Forsea AM, Cretu AN, Ionescu R, et al. Disabling pansclerotic morphea of childhood–unusual case and management challenges. J Med Life 2008;1:348–54. [PMC free article [PubMed] [Google Scholar]

Orteu CH. Morphea and Allied Scarring and Sclerosing Inflammatory Dermatoses. In: Griffiths CE, Barker J, Bleiker T, Chalmers R, Creamer D, editors. Rook's Textbook of Dermatology. 9th ed. Oxford: Wiley Blackwell; 2016. p. 1562.

Florez-Pollack S, Kunzler E, Jacobe HT. Morphea: Current concepts. Clin Dermatol. 2018 Jul-Aug;36(4):475-486. doi: 10.1016/j.clindermatol.2018.04.005. Epub 2018 Apr 10. PMID: 30047431.

Ferreli C, Gasparini G, Parodi A, Cozzani E, Rongioletti F, Atzori L. Cutaneous Manifestations of Scleroderma and Scleroderma-Like Disorders: a Comprehensive Review. Clin Rev Allergy Immunol. 2017 Dec;53(3):306-336. doi: 10.1007/s12016-017-8625-4. PMID: 28712039.

Khatri AM, McLemore M, Malhotra P. Morphea (Localized Scleroderma) Presenting With Recurrent Skin and Soft Tissue Infections: A Diagnostic Dilemma. Cureus. 2020 May; 12(5): e8067.

Albuquerque JV de, Andriolo BNG, Vasconcellos MRA, Civile VT, Lyddiatt A, Trevisani VFM. Interventions for morphea. Cochrane Database of Systematic Reviews 2019, Issue 7. Art. No.: CD005027. DOI: 10.1002/14651858.CD005027.pub5

Kreuter, Alexander & Gambichler, Thilo & Breuckmann, Frank & Rotterdam, Sebastian & Freitag, Marcus & Stuecker, Markus & Hoffmann, Klaus & Altmeyer, Peter. (2005). Pulsed High-Dose Corticosteroids Combined With Low-Dose Methotrexate in Severe Localized Scleroderma. Archives of dermatology. 141. 847-52. 10.1001/archderm.141.7.847.

Qayoom S, Rather S, Manzoor S, Sameen F. Evaluation of corticosteroid and methotrexate therapy in the treatment of moderate to severe localized scleroderma (Morphoea) –A 5 year study in a teaching hospital of North India. International Journal of Contemporary Medical Research 2019;6(5):E1-E6.

Werth VP, 2020. Morphea; Treatment & Management. [online] Available at:

Roldan R, Morote G, Castro Mdel C, Miranda MD, Moreno JC, Collantes E. Efficacy of bosentan in treatment of unresponsive cutaneous ulceration in disabling pansclerotic morphea in children. J Rheumatol. 2006 Dec;33(12):2538-40. Erratum in: J Rheumatol. 2007 Aug;34(8):1786. Dosage error in published abstract; MEDLINE/PubMed abstract corrected. PMID: 17143989.

Wollina U, Buslau M, Heinig B, Petrov I, Unger E, Kyriopoulou E, Koch A, Köstler E, Schönlebe J, Haroske G, Doede T, Pramatarov K. Disabling pansclerotic morphea of childhood poses a high risk of chronic ulceration of the skin and squamous cell carcinoma. Int J Low Extrem Wounds. 2007 Dec;6(4):291-8. doi: 10.1177/1534734607308731. PMID: 18048875.




How to Cite

Sadia A, Sadia A. Pansclerotic morphea: A case report. J Pak Assoc Dermatol [Internet]. 2022Apr.10 [cited 2024Jun.17];31(3):521-5. Available from:



Case Reports