{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:10:04Z","timestamp":1756282204141,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,3,31]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>Bullous morphea is a rare variant of localised scleroderma characterised by skin thickening and blister development. The following case report describes a woman in her 60s diagnosed with bullous morphea. The patient initially presented with a shiny, pruritic rash that spread from her back to her legs. The rash progressed to include fluid-filled bullae. A skin biopsy revealed thickened collagen bundles and epidermal lifting. Differential diagnoses included generalised morphea and lichen sclerosis, but clinical and histopathological findings supported the diagnosis of bullous morphea. The patient was treated with methotrexate, ultraviolet A phototherapy and physical therapy, which halted the progression of her skin thickening. This case highlights the importance of recognising bullous morphea as a unique clinical entity.<\/jats:p>","DOI":"10.1136\/bcr-2025-265039","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T23:35:26Z","timestamp":1744932926000},"page":"e265039","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Bullous morphea: a blistering sclerotic disease"],"prefix":"10.1136","volume":"18","author":[{"given":"Ayema","family":"Haque","sequence":"first","affiliation":[{"name":"Internal Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy","family":"Puga","sequence":"additional","affiliation":[{"name":"Internal Medicine, AltaMed Medical Group Commerce, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison C.","family":"Billi","sequence":"additional","affiliation":[{"name":"Dermatology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9683-6973","authenticated-orcid":false,"given":"Carleigh","family":"Zahn","sequence":"additional","affiliation":[{"name":"Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"2025082700450852000_18.4.e265039.1","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1007\/s12016-017-8625-4","article-title":"Cutaneous Manifestations of Scleroderma and Scleroderma-Like Disorders: a Comprehensive Review","volume":"53","author":"Ferreli","year":"2017","journal-title":"Clin Rev Allergy Immunol"},{"key":"2025082700450852000_18.4.e265039.2","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13154356","article-title":"A Rare Case of Bullous Morphea Associated with Autoimmune Hepatitis","volume":"13","author":"Jokubait\u0117","year":"2024","journal-title":"J Clin Med"},{"key":"2025082700450852000_18.4.e265039.3","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1111\/ced.13127","article-title":"Bullous morphoea: a retrospective study","volume":"42","author":"Venturi","year":"2017","journal-title":"Clin Exp Dermatol"},{"key":"2025082700450852000_18.4.e265039.4","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1590\/abd1806-4841.20164398","article-title":"Extensive bullous lichen sclerosus et atrophicus","volume":"91","author":"Vukicevic","year":"2016","journal-title":"An Bras Dermatol"},{"key":"2025082700450852000_18.4.e265039.5","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1007\/s40257-017-0269-x","article-title":"Morphea and Eosinophilic Fasciitis: An Update","volume":"18","author":"Mertens","year":"2017","journal-title":"Am J Clin Dermatol"},{"key":"2025082700450852000_18.4.e265039.6","doi-asserted-by":"crossref","first-page":"110694","DOI":"10.1016\/j.intimp.2023.110694","article-title":"Immune cells in pemphigus vulgaris and bullous Pemphigoid: From pathogenic roles to targeting therapies","volume":"123","author":"Yuan","year":"2023","journal-title":"Int Immunopharmacol"},{"key":"2025082700450852000_18.4.e265039.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2012.02794.x"},{"key":"2025082700450852000_18.4.e265039.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2011.03.011"},{"key":"2025082700450852000_18.4.e265039.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2005.02209.x"},{"key":"2025082700450852000_18.4.e265039.10","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ad.2016.07.010","article-title":"Bullous Morphea: Description of a New Case and Discussion of Etiologic and Pathogenic Factors in Bulla Formation","volume":"108","author":"S\u00e1nchez-P\u00e9rez","year":"2017","journal-title":"Actas Dermosifiliogr"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265039","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:45:19Z","timestamp":1756280719000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":10,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,17]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bcr-2025-265039"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265039","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}