Congenital Localized Scleroderma: A Rare Presentation in a Newborn Baby

Abstract

Congenital Localized Scleroderma (CLS), is an exceedingly rare form of morphea. Little is known about CLS clinical presentation and progression. Here we describe a case with a unique presentation of CLS noticed since birth. A 2- month-old baby girl presenting with an asymptomatic slightly hyperpigmented oval patch with hypertrophic center and mildly indurated borders involving the left forehead. She had no history of extra-cutaneous involvement. A skin biopsy was obtained and a diagnosis of CLS, circumscribed subtype, was made. Basic laboratory tests, radiological imaging, and ophthalmic examination were all unremarkable, excluding extracutaneous involvement. The patient was started on Topical Tacrolimus 0.1% ointment twice daily. After 12 months of follow-up, the lesion was stable with no signs of activity. This case represented a diagnostic challenge suggesting that CLS should be considered in the differential diagnosis of neonates or infants with fibrotic lesions to avoid delay in the diagnosis, to rule out any underlying systemic involvement, and allow prompt therapy.