Treatment of Localized Scleroderma with Limited Skin Involvement Reaching to the Dermis

This protocol applies to localized scleroderma in which skin involvement reaches to the dermis but does not extend into the subcutaneous fat, fascia, muscle, joints, or bones — and where involvement is not widespread. This specific depth and extent of involvement defines the therapeutic approach.

For cases limited to the skin, guidelines primarily recommend topical therapy. Certain phototherapy modalities appropriate for superficial subtypes are not considered suitable when deeper structures are affected. Accurate characterisation of lesion depth is therefore essential before selecting treatment.

First-line management in the active phase centres on topical therapy, with phototherapy representing a well-supported additional or alternative option specifically for this limited subtype.