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Objectives Background Overlap syndromes involving connective tissue diseases are uncommon and present unique diagnostic and therapeutic challenges especially in resource limited settings. Type 3 overlap syndrome, characterized by the coexistence of distinct cutaneous conditions, is rarely reported. This case report describes an unusual presentation in a young Ivorian patient, contributing to the limited literature on this condition and highlighting the need for multidisciplinary managementMethods Clinical Case A 13-year-old male student from Ivory coast presented with sub acute hyper pigmented, oval macules with adherent scales in a vespertilio pattern on the face, zygomatic regions, and forearms, suggestive of discoid lupus erythematosus (DLE), psoriasis, or dermatophyte infection. Bilateral thigh lesions appeared as indurated, hyper pigmented, atrophic plaques with indistinct borders, consistent with morphea, lupus profundus, or eosinophilic fasciitis. Histopathology revealed orthokeratotic hyperkeratosis, focal epidermal atrophy, and mild lymphoplasmocytic perivascular infiltrates in facial lesions consistent with DLE, while thigh lesions showed atrophic epidermis, basal pigmentation, thickened collagen fibers with horizontalization, and minimal periadnexal inflammation consistent with morphea. Laboratory evaluations, including complete blood count, antinuclear antibody (ANA), and serum electrolytes, were normal, despite reports of abnormalities in severe cases. Treatment included high-potency topical corticosteroids (clobetasol 0.05%, triamcinolone 0.1%, betamethasone), oral hydroxychloroquine (200 mg twice daily), mycophenolate mofetil (1 g twice daily), emollients, sunscreen, and functional physiotherapy. Lesions resolved within one month of therapy.Results This rare case highlights the diagnostic complexity of type 3 overlap syndrome in a young male, requiring clinical-histological correlation. Effective multidisciplinary treatment is essential and further research is needed to optimise diagnostic and management strategies, especially in limited resource settings.Abstract PO:08:210 Figure 1Dermatologic Classification ofOverlap Syndromes in Connective-Tissue DiseasesConclusions This rare case highlights the diagnostic complexity of type 3 overlap syndrome in a young male, requiring clinical-histological correlation. Effective multidisciplinary treatment is essential and further research is needed to optimise diagnostic and management strategies, especially in limited resource settings.