A linear, indurated depression running vertically just to one side of the midline in the frontoparietal region of the scalp is characteristic of en coup de sabre, a variant of morphea.
The alopetic area may extend to the scalp causing an alopetic streak, or it may spread downward to involve the nose, lips, and chin. Rarely, two or even three lines may be present. Extensive lesions may be associated with underlying ocular and central nervous system involvement. For example, seizures or brain calcifications, and ocular changes such as uveitis or episcleritis may occur. Patients may require screening even in the absence of symptoms. Parry-Romberg Facial Hemiatrophy is a related condition on the face.
Usually, prednisone and methotrexate are started as soon as possible to halt disease progression. Once the disease has burned itself out, which may take many years, cosmetic procedures to improve the appearance may be done, e.g. plastic surgery, filler.
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