Morphea is a term used to a form of scleroderma that affects patches of skin.
The cause of morphea is unknown, but it is an autoimmune disorder related to the body's own immune system causing abnormal growth of collagen in the skin.
The symptoms of morphea include reddish patches of skin that thicken into firm, oval-shaped areas. The center of each patch becomes ivory colored with violet borders. These patches sweat very little and have little hair growth.
Morphea patches appear most often on the chest, stomach, and back. Sometimes they appear on the face, arms, and legs.
Localized or Generalized Morphea
- Localized morphea limits itself to one or several patches, ranging in size from a half-inch to 12 inches in diameter. The condition sometimes appears on areas treated by radiation therapy. Some people have both morphea and linear scleroderma (see below).
- Generalized morphea describes the condition when skin patches become very hard and dark and spread over larger areas of the body. Regardless of the type, morphea generally fades out in 3 to 5 years; however, people are often left with darkened skin patches and, in rare cases, muscle weakness.
Linear scleroderma describes a single line or band of thickened or abnormally colored skin. Usually, the line runs down an arm or leg, but in some people it runs down the forehead. The term term “en coup de sabre”, or “sword stroke,” may be used describe this visible line. There can also be atrophy of the affected skin. The distinction between morphea and linear morphea is that morphea does not involve the underlying structures of the skin.
Treatment of Morphea
A skin biopsy will likely be performed to confirm the diagnosis and further categorize the disease.
It can be difficult to effectively treat symptoms of morphea. Fortunately it is generally self-limiting and if it is an easily hidden area may require no treatment at all.
For many, a course of high-potency topical corticosteroids or intralesional corticosteroids may be recommended.
Other treatment options your doctor might consider include topical imiquimod (Aldara®, Zyclara®), a vitamin D analog (Dovonex®, Taclonex®, Vectical®) applied to the skin, calcineurin inhibitors (Elidel®, Protopic®), PUVA light therapy, cyclosporin or surgery.
Image courtesy of Leith Jones.