Bullous Morphea Research Articles

Successful treatment of ulcers of bullous morphea with platelet-rich fibrin therapy

Successful treatment of ulcers of bullous morphea with platelet-rich fibrin therapy

Morphée bulleuse : une forme rare de sclérodermie localisée

Morphée bulleuse : une forme rare de sclérodermie localisée

Painful and oozing bullous lesions in a 74‐year‐old woman

Painful and oozing bullous lesions in a 74‐year‐old woman

Sclerosis and blisters: An uncommon association revealing a new case of bullous morphea

Bullous morphea is a rare variant of localized scleroderma (morphea) characterized by subepidermal bullae developed over sclerotic plaques. The pathogenesis of bullae formation has been the subject of several debates, which arrived at the conclusion of a multifactorial mechanism. We report the case of a 67-year-old patient with bullous morphea of the trunk and thighs, who showed a good response to PUVA therapy combined with topical steroids. Our case report supports the efficiency of PUVA therapy associated with topical steroids as a safe regimen compared to other therapeutic approaches.

An unusual presentation of localized bullous morphea

Bullous morphea is a rare variant of localized scleroderma characterized by occasional intermittent blisters. Lichen sclerosus is a chronic inflammatory disease. The coexistence of morphea and lichen sclerosus has been reported in different sites in the same patient and more rarely in the same lesion. We report the case of a 54-year-old woman with an atypical presentation of bullous morphea and some histological features of lichen sclerosus. She presented with a 5-year history of an ulcerated plaque, with a sclerotic and atrophic center and indurated budding margins, localized on the lumbar back. Initially the diagnosis of a squamous cell carcinoma was suggested. A skin biopsy confirmed the diagnosis of bullous morphea and showed some histological features of lichen sclerosus. Topical betamethasone and silicone gel ointment were prescribed leading to complete healing of the ulceration within five months. Our case is unusual because of the atypical clinical presentation, the histological aspect combining signs of bullous morphea and lichen sclerosus, and the favorable results with the use of local corticotherapy and silicone gel.

Infrapatellar neuralgia due to bullous morphea in postknee arthroplasty patients treated with radiofrequency

Injury or entrapment of the infrapatellar branch of the saphenous nerve (IPS) can cause persistent anterior and medial knee pain. However, IPS neuralgia because of bullous morphea is rare and not reported earlier. We present a case of IPS neuralgia after total knee replacement where the pain was attributed to local skin lesion of bullous morphea (BM). After a successful diagnostic block, radiofrequency treatment was done to provide prolonged relief. We have discussed the possible pathogenesis of nerve entrapment and pain by BM in our case and the basis of treatment by radiofrequency ablation.

A case of generalized bullous morphea

A case of generalized bullous morphea

Morfea Ampollosa tratamiento exitoso con fototerapia UVA 1, calcipotriol y superóxido dismutasa tópico, reporte de un caso

La morfea ampollosa es un tipo infrecuente de morfea, por esta razón existe poca evidencia en la literatura acerca del mejor tratamiento para esta patología. Presentamos el caso de una niña de 10 años a quien se le realizó un diagnóstico de morfea ampollosa, y fue tratada exitosamente con fototerapia UVA-1, calcipotriol y superóxido dismutasa.

A case of Hemorrhagic Bullous morphea

C l i n M e d International Library Citation: Kim H, Kim HS, Cho SH, Lee JD (2015) A case of Hemorrhagic Bullous Morphea. J Dermatol Res Ther 1:011 Received: November 09, 2015: Accepted: November 27, 2015: Published: December 01, 2015 Copyright: © 2015 Kim H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Kim et al. J Dermatol Res Ther 2015, 1:2

Paraneoplastic generalized progressive bullous morphea

Paraneoplastic generalized progressive bullous morphea

Ulcers Caused by Bullous Morphea: Successful Therapy with N-Acetylcysteine and Topical Wound Care

Bullous morphea is an uncommon form of localized scleroderma. The pathogenesis is unknown and treatment of coexistent ulcers is difficult. The pathogenesis of bullae formation in morphea is multifactorial, but reactive oxygen species production appears to play a key role. We report a patient with bullous morphea with long-standing ulcers whom we successfully treated with N-acetylcysteine and topical wound care. N-acetylcysteine, an antioxidant sulfhydryl substance, promotes the healing of ulcers in patients with bullous morphea.

A Case of Lichen Sclerosus et Atrophicus Accompanying Bullous Morphea

Bullous morphea is a rare form of morphea characterized with bullae on or around atrophic morphea plaques. Whereas lichen sclerosus et atrophicus (LSA) is a disease the etiology of which is not fully known, and which is characterized with sclerosis. Coexistence of morphea and LSA has been identified in some cases. Some authors believe that these two diseases are different manifestations which are on the same spectrum. The 70-year-old patient stated herein, presented to us for 6 months with annular, atrophic plaques, ivory color in the middle, surrounded by living erythema, on the front and back of the trunk. Occasionally bulla formation on the plaques on the trunk lateral was identified. Fibrotic and atrophic plaques of ligneous hardness were present on the front side of tibia of both legs. In the histopathologic examination, the lesions were found concordant with bullous morphea and LSA. With colchicine 1.5 mg/day, pentoxifylline 1,200 mg/day, topical calcipotriol ointment and clobetasol propionate cream, the erythema in the patient's lesions faded and softening in the fibrotic plaques was observed. Concomitance of bullous morphea and LSA is a rarely seen, interesting coexistence which suggests a common, as yet unknown, underlying pathogenesis.

Linear Morphea Presenting as Acquired Unilateral Edema

We describe a 2-year-old African-American boy with a 4-month history of gradually worsening unilateral edema that was initially noted on his left hand and then approximately 2 weeks later on his left lower extremity. In addition, linear hypopigmented patches were noted along the left forearm and leg, with no appreciable scarring or induration. The edema on the left-hand side of his body progressed so that he developed tense bullae on his left hand. Two months later, the hypopigmented patches were indurated and bound-down, especially over the left groin and thigh. A biopsy specimen from this area showed features characteristic of morphea. In this patient, dilated lymphatic channels secondary to the sclerosis of the morphea caused the bullae. Bullous morphea is a rare condition. We were unable to find any reports its occurrence in children under 18 with associated lymphedema. This entity should be included in the differential for acquired unilateral edema in children.

Intertriginous bullous morphea: A clue for the pathogenesis?

Bullae occurring in lesions of morphea are uncommon. The cause of bullae formation in morphea is multifactorial, although lymphatic obstruction from the sclerodermatous process is considered the likeliest cause. Bullous morphea may be confused clinically with lichen sclerosus et atrophicus since both diseases may cause bullae in sclerodermatous plaques. A 69-year-old woman presented with a history of generalized morphea diagnosed 9 years earlier; and a 1-month history of pruritic bullae on her inframammary folds, axillary regions, lower abdomen, upper extremities and inguinal folds. Physical examination revealed multiple erythematous erosions, hemorrhagic vesicles and eroded bullae with slight scale or crusts overlying hypopigmented, indurated, shiny plaques. Skin biopsy revealed prominent edema in the papillary dermis, resulting in bulla formation and thickening of collagen fibers within the dermis. Direct immunofluorescence was negative. According to histologic and clinical features, the diagnosis of bullous morphea was established.

Bullous Morphea

A 57-year-old woman who had undergone lumpectomy for infiltrating duct-cell carcinoma of the right breast was found to have morphea after receiving radiation therapy. Three years later she developed a vesicular eruption on the area of the morphea, which was diagnosed as bullous morphea. The histologic findings of the vesicular component were characteristic of lichen sclerosus et atrophicus. It is suggested that in some cases bullous morphea represents a secondary appearance of bullous lichen sclerosus et atrophicus on a lesion of morphea.

Bullous morphea: Clinical, pathologic, and immunopathologic evaluation of thirteen cases

Bullous morphea is a rare disease. Its pathogenesis is unknown. We evaluated bullous morphea clinically, pathologically, and immunopathologically and investigated the role of spirochetes and eosinophils in its pathogenesis. The clinical and pathologic findings from 13 patients with bullous morphea were reviewed. Tissue sections were studied with the Elias-Bosma stain for spirochetes and indirect immunofluorescence for eosinophil granule major basic protein. Bullae were found in all forms of morphea; the lower extremities were the most common sites of involvement. Lymphatic dilatation was found in 77% of the patients. Deposition of major basic protein was found in 60% of cases studied. There was no evidence of spirochetes in any of the specimens examined with the Elias-Bosma stain. Our results suggest that the pathogenesis of bullous morphea is related to lymphatic dilatation as well as release of major basic protein from eosinophils in some patients. We found no association between spirochetes and bullous morphea.