Systemic Sclerosis Manifesting Post-Radiotherapy: A Case Report

Abstract

Morphoea is a chronic inflammatory disease of the skin and underlying tissues, characterised by fibrosis of the skin and subcutaneous tissue without systemic involvement. Radiation-induced morphoea is a rare, often unrecognised, chronically progressive form of radiation-associated localised scleroderma of the skin, infrequently progressing to systemic scleroderma. Systemic scleroderma is characterised by widespread tissue fibrosis along with systemic features, leading to an increased risk of malignancy compared to the general population. The authors present the case of a 67-year-old female, a previously diagnosed case of psoriasis developing squamous cell carcinoma on the ring finger with axillary nodal metastasis, who underwent radiotherapy, and subsequently developed symptoms of systemic sclerosis. This case is unique, as there are nominal reports on generalised morphoea converting to systemic sclerosis post-radiotherapy, along with exaggerated thickening of the skin over the side of radiotherapy. Thus, the authors report this rare side effect of radiotherapy. Treating physicians should always be vigilant in identifying these side effects after radiotherapy to prevent long-term sequelae of the disease, and minimise their impact on the patient’s quality of life.