LAUSR

Dear Editor, A 17-year-old man presented with four hyperpigmented indurated plaques, one over the left post-auricular area and three on the anterior aspect of neck since last 1.5 years. The plaques were gradually increasing in the size. He also noticed an ill-defined atrophic plaque with mild induration, surface erythema, and telangiectasia’s over the left cheek for last 5–6 months. There were no associated systemic complaints. A clinical diagnosis of plaque morphea was considered and a skin biopsy from the plaque over the post-auricular area showed increased dermal thickness with sclerosis of dermal collagen, compatible with the clinical diagnosis of morphea. The patient was treated with oral methotrexate 15 mg per week and 0.05% clobetasol propionate cream twice daily for one month with good improvement in the induration of the plaques. After 1 month, the patient was advised to use tacrolimus 0.1% cream in place of the topical clobetasol propionate and oral methotrexate was continued.