Ultrasonography as an auxiliary diagnostic tool for morphea profunda: A case report

Abstract

Morphea profunda is a rare subtype of localized scleroderma and it is difficult to evaluate the conditions of sclerotic changes at an early stage. Studies using ultrasonography to evaluate localized scleroderma are limited and, to date, the characteristic findings of morphea profunda assessed by ultrasonography have never been reported. Here, we present a case of morphea profunda diagnosed with the assistance of ultrasonography. A 69‐year‐old Japanese woman with a past history of morphea en plaque on her lower abdomen presented with skin indurations of her bilateral lower back and thighs. To evaluate the stiffness of the subcutis, fascia and muscle, we utilized ultrasonography and found an unexpected hyperechogenicity not only of the dermis but also in the deeper tissue. The diagnosis was revised to morphea profunda after we performed a deep skin biopsy, including the muscle tissue. From this case, we assert that ultrasonography is a useful alternative tool to assist in the differential diagnosis of morphea profunda.

Diagnostic Value of Muscle Ultrasound for Myopathies and Myositis

“…In terms of other connective tissue diseases, muscle US has also been used as a diagnostic and follow-up tool in patients with deep morphea, or morphea profunda [44,45]. US of the skin and subdermis in areas with sclerotic plaques can show either inflammation with thickening or atrophy with thinning of the subcutaneous tissue layers, while muscle US will show hyperechogenicity and atrophy in cases with myositis [46].…”

Глубокая Форма Ограниченной Склеродермии: Сонографический Паттерн В Дебюте Заболевания (Случай Из Практики)

“…И если феномен повышения эхогенности дермы, «размытости» границы дермы и гиподермы, а также повышения эхогенности подкожножировой клетчатки в стадию эритемы/отека при ОС отмечали и другие авторы [8,11,12], то появление при глубокой форме ОС в указанную стадию в подкожно-жировой клетчатке достаточно большой и глубоко расположенной зоны пониженной эхогенности ранее никем описано не было.…”