<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article article-type="letter" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML">
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Our Dermatol Online</journal-id>
<journal-title>Our Dermatol Online</journal-title>
<issn pub-type="epub">2081-9390</issn>
<publisher>
<publisher-name>Our Dermatology Online</publisher-name>
<publisher-loc>Poland</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">OURD-9-107</article-id>
<article-id pub-id-type="doi">10.7241/ourd.20181.36</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Letter to the Editor</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Comment: Lipomembranous changes (membrano-cystic lesions) in the extremities of a patient with systemic sclerosis</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Matsumura</surname>
<given-names>Natsuko</given-names>
</name>
<xref ref-type="aff" rid="aff1"/>
<xref ref-type="corresp" rid="cor1"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Yamamoto</surname>
<given-names>Toshiyuki</given-names>
</name>
<xref ref-type="aff" rid="aff1"/>
</contrib>
</contrib-group>
<aff id="aff1"><italic>Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, Fukuoka, Japan</italic></aff>
<author-notes>
<corresp id="cor1">
<bold>Corresponding author:</bold> Dr. Daisuke Tsuruta PhD, E-mail: <email xlink:href="dts211@gmail.com">dts211@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub">
<year>2018</year>
</pub-date>
<volume>9</volume>
<issue>1</issue>
<fpage>107</fpage>
<lpage>107</lpage>
<history>
<date date-type="received"><day>05</day><month>06</month><year>2017</year></date>
<date date-type="accepted"><day>10</day><month>06</month><year>2017</year></date>
</history>
<permissions>
<copyright-statement>Copyright: &#x000a9; Our Dermatol Online 1</copyright-statement>
<copyright-year>2018</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p>
</license>
</permissions>
</article-meta>
</front>
<body>
<sec id="sec1-1">
<title/>
<p>The paper described a possibly rare manifestation of systemic sclerosis (SSc). First of all, skin biopsy for SSc is often problematic and challenging, because of the fear of failure in wound closure. This is known to be caused by vasculature paucity. So, especially for internists, they hesitate to do biopsy. Lipomembranaous changes (LMC) are rarely reported in SSc. LMC are also reported in morphea. Both SSc and morphea mimic each other for skin manifestations, but they are known to be different from the pathomechanical point of view. So, although the pathomechanism of LMC is still unknown, I speculate that LMC may be come from fibrosis commonly found in both SSc and morphea. Further accumulation of cases will elucidate the true pathomechanism of LMC.</p>
</sec>
</body>
</article>