A Rare Triad of Alopecia Areata, Morphea, and Psoriasis in a Patient

Morphea, alopecia areata (AA), and psoriasis are distinct autoimmune disorders with differing clinical features but shared immunological pathways. While dual associations among these conditions have been documented, the simultaneous occurrence of all three remains exceedingly rare. We report a unique case of a woman in her 20s presenting with atrophic plaques over the face, nonscarring alopecia of the scalp, and erythematous scaly plaques typical of psoriasis. Histopathology and dermoscopy confirmed the diagnoses of morphea, AA, and psoriasis, respectively. Laboratory investigations were largely unremarkable except for a weakly reactive antinuclear antibody (ANA) (proliferating cell nuclear Ag). The patient was managed with topical steroids, tacrolimus, and keratolytics. This represents only the second reported case worldwide of this autoimmune triad. The overlapping pathogenesis, particularly involving the Th 17 axis, genetic susceptibility loci, and elevated ANA prevalence, may underlie this concurrence. Further research is needed to elucidate shared immunopathogenic mechanisms and guide tailored therapeutic strategies for such complex co-presentations.