Morphea

What is morphea?

Morphea is a skin condition, also known as localized scleroderma, meaning "hard skin." The skin becomes thick and hard because it contains too much collagen and other proteins.

Localized scleroderma must not be confused with systemic scleroderma. The localized type affects the skin only and does not affect the internal organs. It is extremely rare for the localized type to become the systemic type.

The localized type is often called "morphea" or "morphea scleroderma."

Morphea looks like discoloured patches on the skin

Morphea makes patches called "plaques" or "lesions" appear on the skin. It usually begins with a whitish patch with a purple border. It often has the appearance of a bruise. However, it can look very different from patient to patient. There are several types of morphea and each type looks a little different:

  • Plaque morphea is usually an oval shape with a yellow or ivory colour in the centre and purple at the edges. It may feel thick, firm, and waxy, and may look shiny.
  • Generalized morphea begins as many plaques on the body that may get bigger or join together.
  • Linear morphea appears in a line. It is usually on the arm or leg, and may also occur on the face.

As morphea progresses, the affected skin may change. The veins under the skin may show more clearly. The affected skin may look thinner, and may look raised or sunken compared to the skin around it.

Morphea is uncommon

Morphea is uncommon. It is more common in children and adolescents than it is in adults.

When morphea affects the face, other tissues may be affected. Your doctors may recommend that you should have an eye examination and undergo an MRI of the brain.

Morphea has no known cause

Sometimes morphea seems to happen after an injury. Other times, it seems to happen when a child's immune system is too active. In this case, the body makes too much collagen, and the skin and underlying tissues become inflamed. Morphea is not contagious.

Diagnosis of morphea

Morphea is diagnosed by history and examination. The doctor might take a small part of the skin to send to the lab for tests. There is no blood test to diagnose morphea.

There are several treatments for morphea

Morphea can be treated, but it cannot be cured. Treatment can reduce the inflammation, stop lesions from spreading, and stop new lesions from appearing.

Creams, ointments, and medication

You may be given ointment or creams to put on your child's skin.

Your child may need stronger medication such as prednisone or methotrexate if the morphea is more severe or interferes with your child's movement. Your child may need regular blood tests. These tests monitor the effects and possible side effects of the medication.

Exercise and skin and joint care

Encourage your child to exercise and to stretch. This will keep joints, skin, and muscles flexible.

Make-up

There are special make-up products that can cover the darker or lighter parts of the skin. Ask your doctor about these products.

Monitoring

At each clinic visit your child's skin will be examined. Photographs will be taken to help keep track of changes in the morphea.

Ultrasound or MRI may be used to see if the morphea has affected the deeper tissues under the skin.

Outcome

The active inflammation of morphea may last three to five years. Most children recover very well from morphea.

After the morphea is gone, there may be some change in the pigment (colour) of the skin: it may be lighter or darker than the skin around it.

Skin and other tissues may atrophy (loss of tissue). The fatty tissue under the skin may disappear. This will make affected areas look thinner and have a different texture.

Key points

  • Morphea is an uncommon condition that causes skin to harden and look bruised.
  • Morphea is treated with creams, ointments and/or medications.
  • The active inflammation of morphea stops after several years.

Ronald M. Laxer, MDCM, FRCPC

Christine O'Brien, BSc, OT Reg (Ont), MSc

7/15/2015




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