TACROLIMUS 0.1% OINTMENT THERAPY FOR MORFEA SIRKUMSKRIPTA

Morphea is rare fibrosis of the skin and still no recommended and satisfaction therapy. Tacrolimus is an option for the active phase therapy of morphea which have not responsive to topical steroids. A 29-year-old woman complained of appearing violaceous-red patches on the forehead for 5 years ago followed by the same lesion on the left cheek for 1 year. The lesions become thicker and wider. The patient also complained of a hollow in the middle of the forehead 2 years ago. The patient was treated with dexosimethasone cream for 8 weeks but there was no improvement. Dermatological examination of the frontalis region showed atrophic skin surrounded by violaceous erythema plaques, the left maxillary region showed violaceous erythema plaque lesions. Raynaud's phenomenon and ANA test was negative. Schedel examination within normal limits. Histopathological examination showed solid fibrocollagen in the dermis surrounded by lymphocyte infiltrates. Initial scores of Dyspigmentation, Induration, Erythema and Telengiectasis (DIET) on the frontalis area was 4, and the maxillary region was 5. Modified Localized Scleroderma Score Skin Severity index (mLoSSi) on the frontalis region was 3, and the maxillary region was 5. The patient was given tacrolimus 0.1 % ointment and after 8 weeks, there was an improvement in the lesion. The DIET score decreased on the frontalis region become 1, and in the maxillary region become 3, the mLoSSi score also decreased, on the frontalis region become 1 and the maxillary region 2. Tacrolimus 0,1% ointment proved to be a successful treatment for patients with circumscribed morphea.

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