Nodular morphea keloidal type: A rare case with paradigmatic histopathology significantly accompanied by a flawless surgical scar

Abstract

Nodular morphea is a rare variant of localized scleroderma, clinically and histopathologically characterized by cutaneous nodules or plaques associated or superimposed to the flat lesions of classic morphea. Accordingly, the association of such outgrowths with systemic sclerosis is designated as nodular scleroderma. Sometimes these lesions appear as firm, erythematous and irregularly curvy plaques resembling keloids or hypertrophic scars, thus characterizing keloidal morphea or keloidal scleroderma. These mystifying features can make the diagnosis challenging, especially in the absence of a well‐documented medical history. Here we report a case of keloidal morphea with multiple histopathologically typical nodules in the absence of clinical or laboratory signs of scleroderma, whose clinical diagnosis was suggested by a concomitant normally cicatrized scar from quadrantectomy.