A case series of dermatopathological features in different types of morphea and their clinical correlates

The dermatopathological features in morphea (localized scleroderma) and their clinicopathologic correlations are not well described in the literature. To describe dermatopathological changes of different types of morphea and to investigate the association between clinical and histopathological features. A total of 18 cases of morphea who attended our tertiary care center in the last four years were evaluated. We noted clinical characteristics of all patients and dermatopathological changes like the pattern of sclerosis, degree of inflammation, cell types and all epidermal-dermal, and appendageal changes. Clinicopathological correlation was performed to interpret the clinical significance of dermatopathological changes in various types of morphea. Morphea was most commonly noted in the third decade and females. A circumscribed plaque was the most common clinical presentation. Full-thickness pattern of sclerosis was significantly associated with various clinical outcomes. Basal pigmentation and a reduced number of appendages were noted in more than 80% of patients. All patients had various grades of inflammation. Severe and moderate-grade inflammation with eosinophils and plasma cells was associated with pruritus and/or pain. The limitations are small sample size and single-centered case series. The dermatopathological examination of morphea may help in better monitoring and treatment of patients, including patterns of sclerosis and grades of inflammation, and cell types in skin pathology reports will aid in proper and better clinical management.