A patient born in 1988 was admitted to the dermatology department of TashPMI clinic from Angren city, complaining of a thickening on the skin of the left frontal bone, left supraorbital area, extending to the bridge of the nose and hairy scalp, resembling a saber cut, loss of appetite, weakness, and rapid fatigue. According to his mother, he has been ill for 2.5 years. The illness was preceded by follicular tonsillitis, after which a painless, dense, shiny erythematous linear area appeared on the skin of the left frontal bone. Subsequently, the lesion slowly enlarged, extending to the hairy scalp with large focal alopecia, to the left supraorbital ridge and the bridge of the nose. The distal edge of the lesion hardened, while the proximal (on the hairy scalp) was replaced by brown pigmentation, with the skin within the lesion gradually atrophying. The patient had repeatedly visited a local dermatologist; localized scleroderma of linear form was diagnosed, several courses of antibiotic therapy, resorptive, vitamin, and hormone therapy were carried out. There was virtually no effect; the dermatological process progressed.
Dermatological examination: Asymmetric, non-inflammatory, located on the skin of the left frontal bone, left supraorbital ridge, extending in a saber cut pattern to the bridge of the nose. The process involves the hairy scalp, where there is large focal alopecia. The pathological focus is clearly demarcated from the surrounding tissue, slightly recedes, has a purplish-red border. Within the lesion, the skin is atrophied, parchment-like, fused with surrounding tissues, does not fold. No subjective sensations. There is marked facial asymmetry with signs of hemiatrophy and anophthalmia. Downy hairs on the left forehead are completely gone, the left eyebrow is significantly thinner than the right (see picture). Skin temperature on the left bone is 0.8-1.2°C lower than on the right. A pediatrician found no internal organ pathology. No visible pathology on the overview radiograph. An ENT doctor diagnosed chronic compensated tonsillitis.
In the dermatology department of TashPMI clinic, the patient received 15 sessions of RT. Both general and local emitters were used: GI - general action with gradually increasing exposure time from 15 to 65 minutes, KL - on the hypothalamus area for 15 minutes; ZB - directly on the affected area - 15-20 minutes. Simultaneously, the patient received medication therapy: lidase, vitamin B1, B6, nicotinic acid, ascorbic acid. No local ointment therapy was applied. After treatment, general condition improved, sleep and appetite normalized. In the pathological focus, the peripheral purplish rim disappeared, the scleroderma plaque became softer, its edges slightly smoothed, the skin began to fold slightly, pigmentation decreased. Pre-capillary collaterals develop around the atrophy focus. The patient was recommended a repeat treatment course after a three-week break.
Dermatological examination: Asymmetric, non-inflammatory, located on the skin of the left frontal bone, left supraorbital ridge, extending in a saber cut pattern to the bridge of the nose. The process involves the hairy scalp, where there is large focal alopecia. The pathological focus is clearly demarcated from the surrounding tissue, slightly recedes, has a purplish-red border. Within the lesion, the skin is atrophied, parchment-like, fused with surrounding tissues, does not fold. No subjective sensations. There is marked facial asymmetry with signs of hemiatrophy and anophthalmia. Downy hairs on the left forehead are completely gone, the left eyebrow is significantly thinner than the right (see picture). Skin temperature on the left bone is 0.8-1.2°C lower than on the right. A pediatrician found no internal organ pathology. No visible pathology on the overview radiograph. An ENT doctor diagnosed chronic compensated tonsillitis.
In the dermatology department of TashPMI clinic, the patient received 15 sessions of RT. Both general and local emitters were used: GI - general action with gradually increasing exposure time from 15 to 65 minutes, KL - on the hypothalamus area for 15 minutes; ZB - directly on the affected area - 15-20 minutes. Simultaneously, the patient received medication therapy: lidase, vitamin B1, B6, nicotinic acid, ascorbic acid. No local ointment therapy was applied. After treatment, general condition improved, sleep and appetite normalized. In the pathological focus, the peripheral purplish rim disappeared, the scleroderma plaque became softer, its edges slightly smoothed, the skin began to fold slightly, pigmentation decreased. Pre-capillary collaterals develop around the atrophy focus. The patient was recommended a repeat treatment course after a three-week break.