A young woman developed this long, linear induration with color change along the left inner leg.

LINEAR MORPHEA

Linear scleroderma (LM-linear morphea) is a form of localized scleroderma characterized by sclerotic lesions distributed in a linear, band-like pattern. It is more common in children but occurs in adults as well.

• The mean age of initial diagnosis is 7-8 years.
• Sclerotic lesions distributed in a linear, band-like pattern.
  
• It is more common in children but occurs in adults as well.
• LM may inovlve the underlying subcutaneous tissue and muscle
  
• There may be mild to severe joint contractures
• MRI may be useful in the workup.

A band-like linear induration, often with hypo or hyperpigmented areas, most commonly on the leg but also arm and forehead (en coup de sabre) is characteristic. A deep component with fixation to underlying structures may be present. Joint pain is quite common and joint contractures due to skin and tissue involvement may occur. Twenty percent of patients have onset by age 10; 75% by age 40. An underlying sclerosing bone dysplasia called melorheostosis can occur with the X-ray appearance said to resemble dripping candle wax. ANA may be strongly positive but often the diagnosis is made clinically.

RegionalDerm

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