Brief Answer:
possibility of en coup de sabre; upload an image

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. kakkar. I have gone through your query and I have understood it.

I would keep a possibility of Linear Morphea/scleroderma. The other name of Linear scleroderma on forehead is en coup de sabre, given the resemblance of the skin lesions to the stroke of a sabre.

It presents as a linear band of hard bound, sclerotic skin, extending vertically on the forehead and extending variably into the scalp (with associated hair loss).

There is atrophy of the skin and subcutaneous tissue along this band; atrophy may extending to the level of bone as well thus giving rise to asymmetry.

I would appreciate if you could upload a few pictures as well, so that I can be able to help you better

Clinically, it is manifested by ivory-colored, sclerotic plaques distributed in a band-like fashion on the frontoparietal scalp and forehead.

Alopecia / hair loss of the affected scalp is common and often the presenting complaint.
Lesions may extend down the forehead to the nose, cheek.

The diagnosis is a clinical one and it is usually a self-limited disease.

Management options are Topical, intralesional, and systemic steroids; Topical Vitamin D3 Analogues like calcipotriol; Topical PUVA with UVA 1 therapy; Oral antimalarials like Hydroxychloroquin

Regression or softening of skin lesions often occurs with or without treatment, but complete resolution is unusual.
Bone involvement and asymmetry is permanent.

Topical steroids help lighten the patch and are a commonly prescribed treatment.
Phototherapy and systemic steroids are mainly for progressive disease.


Regards

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Brief Answer:
topical steroids would lighten the patch

Detailed Answer:
Hi.

I have reviewed the Images

Topical steroids e.g mometasone furoate Or Clobetasol propionate would definitely help lighten the patch.

Systemic steroids, hydroxychloroquin and/or phototherapy may also be considered for deeper involvement in case of progressive disease.

These are prescription drugs and therefore I suggest you to visit a dermatologist for the needful.

Regards

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Brief Answer:
I suggest morphea as part of parry romberg syndrome (PRS)

Detailed Answer:
Hi

After reviewing the Images I would rather keep a differential of Parry Romberg syndrome which comprises hemifacial atrophy (involving skin muscle and even bone) along with morphea (en coup de sabre).
The hemifacial atrophy may involve the forehead, eye (enophthalmos), mouth, nose and lips.
Asymmetry of one side of face cannot just be explained by morhea patch on forehead. Rather, facial hemiatrophy is part of the syndrome (PRS)

Plastic surgery is not advisable till the progression is over.

Topical steroids and chemical peels would definitely lighten the morpheic patch.

I suggest you to go through the link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/

Regards

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