Concurrent presentation of cutaneous lesions of deep linear morphoea and discoid lupus erythematosus

Morphea Profunda with Tertiary Lymphoid Follicles: Description of Two Cases and Review of the Literature

Morphea profunda or subcutaneous (deep) morphea is a variant of localized morphea, characterized by one or more ill-defined, deep sclerotic plaque. Preferential sites are the abdomen, trunk, sacral area, or extremities. The presence of hyperplastic lymphoid follicles in the context of the sclerotic bands of morphea is rarely described. Localized scleroderma is sustained by a profibrotic inflammatory profile. Transforming growth factor-β (TGF-β), an imbalance between functional subclasses of T-lymphocytes (innate immune cells) has a role in activate collagen deposition. In this case report, we present two cases of morphea profunda with lymphoid follicular hyperplasia. A systematic review of the literature on the pathophysiology of localized scleroderma is also presented, with particular reference to the presence of lymphoid structures.

Adult-onset linear discoid lupus erythematosus on the forehead mimicking en coup de sabre: a case report

Background

Linear cutaneous lupus erythematosus (LE) is an unusual form of LE-specific cutaneous condition, occurring in children and young adults. Due to its rarity, the diagnosis of linear cutaneous LE can be difficult and facial lesions can resemble linear morphea or en coup de sabre. Differential diagnosis of similar conditions along the lines of Blaschko must be differentiated from linear LE.

Case presentation

We report a case of linear discoid LE on the forehead of an adult female Thai patient mimicking en coup de sabre. The dermatoscopy, histopathology and direct immunofluorescence findings were consistent with chronic cutaneous LE.

Conclusions

As this patient demonstrated classic dermatoscopic features of LE, we emphasized that the diagnosis of linear cutaneous LE can be made by dermatoscopy. This is particularly beneficial for young self-conscious patients with facial lesions that are reluctant to perform skin biopsy.