Three Cases of Trauma-induced Development of Isomorphic Lesions in Morphea

Jun, Jae Hong; Lee, Chang Woo

Abstract

We describe three cases of morphea which present lesions of the disease at the site of mechanical traumas. In these patients, local traumatization of cutaneous tissue appear to be the initiating event for the developrnent of new lesions (isomorphic phenomenon) associated with their possible morphea prone constitutions. The mechanism involving these local stimuli responsible for the excessive collagen production is lifficult to explain. Upon biologic stress or trauma, normal cutaneous physiology may cause loca production and release of inflammatory mediators/cytokines, such as transforrning growth factor-beta(the major connective tissue growth factor-inducer). Perhaps, possible dysregulation of collagen-growth or fibrosis- promoting cytokines causing some clonal overactivity of the fibroblast, or with other undefined mechanisms may cause excessive synthesis of collagen to the local effects of such triggering factors in susceptible/subclinical individuals. Although no definite environrriental/physical influences on the developrnent of morphea have been described, rnechanical trauma niay occasionally be regarded as a contributing factor as seen in these patients.