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Case Reports in Rheumatology
Volume 2011, Article ID 951948, 4 pages
http://dx.doi.org/10.1155/2011/951948
Case Report

Generalized Morphea after Breast Cancer Radiation Therapy

Department of Rheumatology, Medical College of Wisconsin, FEC 4764, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA

Received 24 August 2011; Accepted 15 September 2011

Academic Editor: C. Schubert

Copyright © 2011 Jonathan Kushi and M. E. Csuka. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We present a case of a 69-year-old woman who received external beam radiation for the treatment of breast cancer. Seven months later, she developed generalized morphea involving the area of irradiated skin of the breast as well as distant sites of the groin and distal lower extremity. Postirradiation morphea is an uncommon yet well-documented phenomenon, usually confined to the radiated site and the immediate surrounding tissue. To our knowledge, this is only the fourth reported case of morphea occurring distant from the radiation field. While most cases of postirradiation morphea have been shown to either resolve spontaneously or respond to topical corticosteroids, our patient required systemic therapy with methotrexate, which resulted in clinical improvement. With this paper, we hope to bring further awareness to this phenomenon and demonstrate a successful treatment response with the use of methotrexate in postirradiation generalized morphea.