Diagnosis of Localized Scleroderma Assisted by Magnetic Resonance Imaging

Park, Sang Yeon; Choi, Eung Ho

Abstract

Localized scleroderma, also known as morphea, is characterized by skin hardening caused by increased collagen deposition. Since lesions are usually limited to the skin and subcutaneous fat tissue, its prognosis is usually good. However, it can extend over muscular fascia, muscle tissue and tendons; thus, early diagnosis and treatment are important. Although the diagnosis of scleroderma is based on clinical manifestations and histopathologic findings, it is sometimes delayed due to nonspecific clinical appearances. Magnetic resonance imaging (MRI) visualizing the internal structures of the body can evaluate soft tissue lesions very well and is helpful in diagnosis as well as diagnosing extension of scleroderma. A 49-year-old woman complained of a 10-cm-diameter skin colored hard plaque on her right upper arm, which was suspicious due to muscular involvement. The MRI revealed subcutaneous fat and interlobular septa over the deltoid muscle showing high signal, but no change in the underlying muscle or bone. We report here a case of localized scleroderma that developed in a 49-year-old Korean woman. The diagnosis was assisted by MRI with regards to the depth and extension of invasion.