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The “tank top sign”: a unique pattern of skin fibrosis seen in pansclerotic morphea
  1. N S Sherber,
  2. F Boin,
  3. L K Hummers,
  4. F M Wigley
  1. Johns Hopkins Scleroderma Center, Baltimore, Maryland, USA
  1. Correspondence to Dr N S Sherber, Johns Hopkins Hospital, Department of Dermatology, 601 North Caroline Street, 6th Floor, Baltimore, MD 21205, USA; sherber{at}jhmi.edu

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Pansclerotic morphea is a rare form of localised scleroderma in which inflammation in the dermis and subcutaneous fat leads to diffuse cutaneous sclerosis.1 It typically presents in childhood, but cases of adult-onset pansclerotic morphea have been reported, generally associated with a progressive course and poor response to traditional immunosuppressive therapy.2

Between 2000 and 2008, three men with pansclerotic morphea presented to the Johns Hopkins Scleroderma Center with striking similarity in the distribution of fibrotic plaques on the upper chest that spared the areolae and lateral pectoral region and involved the whole back. This gave the appearance that each patient was wearing a “tank top” …

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