Abstract

Morpheas are characterized by cutaneous induration (sclerosis), evidence of fibrosis of the dermis and sometimes of the underlying tissues without recognized etiology. We report a case of linear Morpheus in saber cut with aesthetic repercussions. A 17-year-old Malian boy consulted for a hypochromic strip of the face and scalp that had been evolving for 8 months. The lesion began with a non-pruritic and slightly painful erythematous spot. On inspection, it was a slightly atrophic hypochromic band, 2 cm wide and 12 cm long extending from the head of the left eyebrow to the vertex. Palpation found cutaneous sclerosis along the entire length of the band. There was no Raynaud's phenomenon or sclerodactyly. The rest of the clinical examination was normal. A biopsy of the lesion with anatomopathological examination was performed and the diagnosis of morphea was retained. The biological assessment carried out did not show any inflammatory syndrome or antinuclear factors. The skull x-ray did not find any bone abnormality. Treatment with systemic corticosteroids (prednisone) at a rate of 1 mg/kg/day associated with methotrexate 20 mg/week was introduced. After 3 months of well-monitored treatment, the evolution was favourable, with stabilization of the skin band. Morpheas cause aesthetic or functional damage that is sometimes significant. Their management must take into account the quality of life of affected subjects whose life expectancy is considered normal with an assessment of the risk- benefit of potentially aggressive therapies.

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