Cape Breton, Nova Scotia
The patient is a 37 year old woman with a four year history of a slowly progressively asymptomatic area of induration on the posterior aspect of the left thigh (photo). A biopsy showed thickened collagen bundles in the reticular dermis and a sparse superficial and deep lymphoplasmacytic infiltrate consistent with morphea.
Strangely, her father-in-law is seriously ill with systemic sclerosis. He lives far from the patient and her husband. At this time, we have discovered no common exposures the patient and her father-in-law have. The patient lives in an endemic area for Lyme Disease and serological testing will be offered.
Is there any value in obtaining serologies, other than Lyme studies, on this woman?
What treatment might be of value?
Do you have alternate diagnoses?
1. Localized Scleroderma Review Article (Like a chapter in a text book)