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Fig. 1A —9-year-old boy with deep pansclerotic disabling morphea. Photomicrographs show dermis is increased in thickness and composed of broad sclerotic collagen bundles. Collagen has replaced fat around sweat glands (arrowhead, A) and extends into subcutis. Eccrine glands are situated at relatively high level in dermis as a result of collagen deposited below them. Scattered lymphocytes are located around blood vessels (long black arrow, A). Note dense collagenization of dermis and extension of fibrous tissue (short black arrow, A) into subcutaneous fat (white arrow) (A) (H and E, x50) and musculature (long arrow, B) are shown in this patient with deep morphea. Below sclerotic subcutis, collagen bundles (short arrows, B) are located between skeletal muscle fibers (long arrow, B) in deep morphea (B) (Van Gieson stain, x100).