Morphea Profunda

A 51-year-old Japanese male developed morphea profunda over a plaque of pigmented sweating skin on the left chest extending deeply into the lung. Eight years previously, he noted a brown pigmented spot on the left axilla which started to enlarge over the left chest in a band-like manner. Later, the involved skin hardened with profuse sweating. Chest X-ray examination and computer tomography revealed a thickening of the left chest wall and a nodular mass lesion in the left lower lung field. Biopsy specimens from lung, chest wall, and overlying skin revealed a granulomatous tissue in the parenchyma and a marked fibrosis extending from the deep dermis to the pleura. There were no findings suggestive of malignancy or chronic infectious disease. We assume that the process of morphea in this patient extended deeply from the skin to the lung.