Morphea

Morphea is a localized form of scleroderma, a chronic autoimmune disease characterized by hardening and thickening of the skin. Unlike systemic sclerosis, morphea primarily affects the skin and underlying tissues, and generally does not involve internal organs.

Characteristics:

• Skin Changes: The hallmark of morphea is the development of oval or linear patches of thickened, discolored skin. These patches often start as red or purplish areas that gradually become ivory-colored and hardened in the center, sometimes with a violaceous (purple) border.
• Location: Morphea can occur on any part of the body, but is most common on the trunk, arms, legs, and face.
• Types: Several subtypes of morphea exist, including:
  • Localized morphea (plaque morphea): The most common type, characterized by one or more oval-shaped patches.
  • Generalized morphea: Involves multiple widespread patches of skin hardening.
  • Linear morphea: Appears as a band or line of hardened skin, often on an arm or leg. In children, linear morphea on the face or scalp can cause significant growth problems and cosmetic issues (coup de sabre).
  • Deep morphea (morphea profunda): Affects deeper layers of the skin and underlying tissues, including muscle and fat.
  • Bullous morphea: A rare form characterized by blisters on the affected skin.
• Symptoms: Aside from skin changes, morphea can cause itching, pain, numbness, and restricted movement if it affects joints. The severity of symptoms varies depending on the type and extent of the disease.

Causes:

The exact cause of morphea is unknown. It is believed to be an autoimmune disorder in which the body's immune system mistakenly attacks its own tissues. Genetic predisposition, environmental factors, and infection may play a role.

Diagnosis:

Diagnosis is typically based on a physical examination of the skin and may be confirmed by a skin biopsy.

Treatment:

There is no cure for morphea, but treatment can help control symptoms and prevent further progression. Treatment options include:

• Topical corticosteroids: To reduce inflammation.
• Topical calcipotriene: A vitamin D analog that can help soften the skin.
• Phototherapy (UV light therapy): To reduce inflammation and improve skin texture.
• Systemic medications: Such as methotrexate, corticosteroids, or mycophenolate mofetil, may be used for more severe or widespread cases.
• Physical therapy: To maintain joint mobility and prevent contractures, especially in linear morphea.

Prognosis:

The prognosis for morphea varies depending on the type and severity of the disease. Localized morphea often resolves spontaneously within a few years, although the skin discoloration may persist. Linear and generalized morphea tend to be more chronic and may require long-term treatment. Morphea profunda can cause significant disability if it affects muscles and joints.