Case Report: Late onset of generalized isomorphic morphea in a postmenopausal woman

Morphea is an inflammatory, sclerosing skin condition of unknown cause that generally does not present systemic manifestations. A 66-year-old Caucasian Peruvian female patient, who was previously a nurse, presented with a prior history of 4 years of indurated dermal plaque lesions with constant progression. Diagnosis of morphea was made by clinical examination and skin biopsy. The patient started topical treatment with methoxsalen and phototherapy. When no improvement was seen, it was switched to methotrexate. However, due to changes in liver profile, phototherapy was restarted with progressive clinical improvement. It is essential to differentiate all morphea subtypes for proper management.