Prezentam cazul unui pacient in varsta de 45 de ani, neexpus la noxe profesionale, la care afectiunea a debutat, fara afectarea starii generale, prin aparitia unor placi circumscrise, cu localizare pe trunchi - anterior si posterior - si tendinta la confluare in etajul abdominal superior, indurate, cu partea centrala de culoare galben-ceroasa si marginea distincta de culoare violacee -liliac inel - cu suprafata neteda si lucioasa, avand evolutie persistenta, fara tendinta la remisiune spontana.

Aceste caractere clinico-evolutive pledeaza pentru diagnosticul de sclerodermie localizata - forma „in placi", diagnostic sustinut de examenul histopatologic, precum si de alte investigatii paraclinice de excludere a oricarei afectari sistemice.

Intentia de modulare a proceselor inflamator si de fibroza localizata a tesutului conjuctiv dermic s-a concretizat in cateva etape terapeutice succesive cu beneficiu limitat printr-un raspuns putin satisfacator al afectiunii la tratament si printr-o complianta redusa a pacientului. Afectiunea a evoluat spre morfee generalizata - fara afectare acrala si viscerala - ceea ce a impus reconsiderarea terapiei si utilizarea proprietatilor PUVA de modulare a capacitatii de bio sinteza a fibroblastelor dermice.

We will present the case of the 45 years old patient, who haven't a noxius profession and a good health, he had on the begining only circumscribed, sclerotic plaques with localization on the trunk - anterior and posterior - with tendency to confluence in the apper abdominal level, who have an ivory - coloured center and a characteristic lilac - coloured edge, with a smooth and shiny surface; these plaques had a persistent evolution without tendency to the spontaneous improvement.

These specific clinical features quide us to the diagnosis is sustained by histopathologicall exam and other paraclinical researchs who exclude any systemic affection.

Our intention to modulate the inflammatory and fibrous process of the dermal connective tissue have been make in the same succesive thertapeutics steps; these had a limited benefit through a poor response of affection at the treatment and by a poor collaboration from the patient. His affection developed to generalized morphea - without visceral and acral affection - and this made us to revaluate the treatment and to utilize PUVA - property to modulate the capacity of the dermal fibroblasts biosynthesis.