Case Report DOI: 10.7241/ourd.20132.39 Our Dermatol Online. 2013; 4(2): 172-175 Date of submission: 18.01.2013 / acceptance: 20.02.2013 Abstract Localized scleroderma (also called morphea) is a term encompassing a spectrum of sclerotic autoimmune diseases that primarily affect the skin, but might also involve underlying structures such as the fat, fascia, muscle, and bones. Morphea profundus presenting with atrophic lesions has rarely been reported in the literature. Here we report two cases of morphea profundus presenting with noninlammatory depressed plaques, without any signiicant skin induration, pigmentation or textural change. Histopathology was conirmatory for morphea profundus. Key words: morphea profundus; atrophic; multiple Introduction The term „morphea” includes a wide spectrum of clinical entities, varying from localized plaques of only cosmetic importance to deep lesions resulting in considerable morbidity for the patient. Four different types of deep morphea have been distinguished: Subcutaneous Morphea, Eosinophilic Fasciitis, Disabling pansclerotic morphea and Morphea Profundus [1]. Morphea profundus is a rare disease and it often has a progressive course with physical and psychological sequelae [2]. Morphea profundus usually presents with early induration followed by atrophy of subcutaneous tissue and on occasion that of muscle [3]. Here we report two cases of atrophic morphea profundus presenting without any signiicant skin induration, pigmentation or textural change, the published literature on this type of presentation is sparse. Case Report Two female patients presented to us with asymptomatic atrophy of skin on multiple sites of the body. Case-1: Our irst patient was 24 years old and irst noticed circumscribed swelling on left arm 2 years back. It was small to begin with and later gradually increased in size and further, after 4-5 months she noticed atrophy of the skin in the same region. She noticed similar lesions adjacent to the old lesion on left arm and also on right arm and on left side of face at inner margin of eye. On examination, there were atrophic areas on her left upper arm (Fig. 1) and right upper arm (Fig. 2) with ill-deined margins. The skin overlying the lesions showed no obvious induration or tenderness. Multiple nodules were present varying in size from 2cm × 1cm to 5cm ×3 cm, hard in consistency, mobile, with skin pinchable over them, distal to the atrophic areas. Swelling of the face involving left lower eyelid and maxillary region measuring about 6 cm × 8 cm was present (Fig. 3). Examination of the surrounding skin, hair, nails and other systems did not reveal any abnormality. Case-2: Our second patient was 16 years old and presented with asymptomatic atrophy of the skin of both upper arms and right side of face since seven months. It was irst noticed on her right arm followed in a few months by similar lesions gradually appearing on her left arm and her face. On examination, atrophic areas on right side of face (Fig. 4), with ill-deined margins and patchy loss of hair was present in temporal, maxillary and mandibular region. Atrophic areas were also present on right upper arm (Fig. 5) and left upper arm (Fig. 6).The skin overlying the lesions showed no induration or tenderness. Both patients did not complain of pain, redness or itching on these areas. www.odermatol.com Source of Support: Nil Competing Interests: None Cite this article: Leena Raveendra, Belliappa Pemmanda Raju, Umashankar Nagaraju, Vivekananda, Priya Kootelu Sundar, Lokanatha Keshavalu: Atrophic type of morphea profundus - an Indian experience. Our Dermatol Online. 2013; 4(2): 172-175 ATROPHIC TYPE OF MORPHEA PROFUNDUS - AN INDIAN EXPERIENCE Leena Raveendra, Belliappa Pemmanda Raju, Umashankar Nagaraju, Vivekananda, Priya Kootelu Sundar, Lokanatha Keshavalu Department of Dermatology, Rajarajeswari Medical College and Hospital Kambipura, Kengeri Hobli, Mysore Road, Bangalore, India Corresponding author: Dr Leena Raveendra cbleena@gmail.com 172 © Our Dermatol Online 2.2013