Physiotherapy Approach in Linear Scleroderma of the Lower Limb: A Case Report

Linear scleroderma is a subtype of localized scleroderma that may affect deeper tissues, including fascia and muscle, leading to joint restriction, gait abnormalities, and functional impairment. Evidence based physiotherapy management in these patients remains limited. We report the case of a 17-year-old female with juvenile linear scleroderma affecting the left lower limb, involving dermatomes L3–L4 and fibrosis of the m. Sartorius, m. Rectus femoris, and m. Vastus lateralis. Previous medical treatment included systemic corticosteroids and methotrexate; however, long-term functional progress was limited, and treatment tolerance was poor. Before initiation of our physiotherapy intervention, no clearly visible functional or structural improvement had been documented. A five-month individualized physiotherapy program was delivered once weekly (60 minutes/session). Treatment consisted of myofascial release, manual therapy, proprioceptive neuromuscular facilitation, dry needling, static and dynamic cupping therapy, strengthening exercises, movement re-education, and a home exercise program including foam rolling. Following intervention, clinically meaningful improvements were observed in hip and knee mobility, lumbopelvic movement control, gait symmetry, and overall functional performance. Soft tissue quality improved, with reduced induration, increased mobility, and decreased visible contour irregularities of the affected thigh. The patient also reported improved well-being and easier participation in daily and sports activities. No worsening of disease status was observed during the treatment period. This case suggests that individualized physiotherapy may be an effective adjunctive treatment approach in juvenile linear scleroderma of the lower limb. Further research is required to determine optimal rehabilitation strategies and long-term outcomes.