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This study describes the clinical course, autoimmune co-morbidities, complications, and treatment of adults with PRS\/ECDS at a tertiary referral center. We retrospectively reviewed the records of all 34 adult patients with PRS\/ECDS identified through billing code search and seen by dermatologists at our institution between 2015 and 2021. Eight patients (23.5%) had ECDS, 8 (23.5%) had PRS, and 18 (52.9%) had overlap. Twenty-six patients (76.5%) reported ocular, oral, and\/or neurologic symptoms, and 8 (23.5%) had concomitant autoimmune\/inflammatory conditions. Sixteen patients (47.1%) had a skin biopsy, and 25 (73.5%) had imaging. Forty-six MRIs were obtained, of which 6 (13.0%) reported intracranial findings and 25 (54.3%) reported disease-related connective tissue damage. Twenty-four patients (70.6%) underwent systemic treatment during their disease course per available clinical records. Seventeen patients (70.8%) had improved or stable disease upon treatment completion, with an average duration of 22.2\u00a0months. Ten patients (41.7%) reported recurrence of disease following the treatment course. To address changes to facial contour, 6 patients (17.6%) opted for procedural treatments. One patient (16.7%) experienced morphea reactivation following a filler injection performed off-immunosuppression. Compared to findings in children, our study suggests adults with PRS\/ECDS are more likely to have oral and ocular complications but experience less severe neurologic symptoms. While systemic treatments appear beneficial in most adult patients with PRS\/ECDS, disease may recur following discontinuation.<\/jats:p>","DOI":"10.1007\/s00403-022-02478-1","type":"journal-article","created":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T07:47:40Z","timestamp":1669967260000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical and therapeutic course in head variants of linear morphea in adults: a retrospective review"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8993-4026","authenticated-orcid":false,"given":"Winnie","family":"Fan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4274-2830","authenticated-orcid":false,"given":"Bianca","family":"Obiakor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Jacobson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Haemel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1212-1136","authenticated-orcid":false,"given":"Jocelyn","family":"Gandelman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,12,2]]},"reference":[{"issue":"2","key":"2478_CR1","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/j.jaad.2006.10.959","volume":"56","author":"MM Tollefson","year":"2007","unstructured":"Tollefson MM, Witman PM (2007) En coup de sabre morphea and Parry-Romberg syndrome: a retrospective review of 54 patients. 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