Chris Schach

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Key Points
*Uncommon skin condition which may affect various areas of the body
*Exact cause is unknown
*Consists of areas of skin which become thickened

Morphea, also called localized scleroderma, is an uncommon skin condition, often persistent, which may appear in various areas of the body. The condition, in its most common form (plaque), consists of the development of thickened areas of skin, typically on the torso and/or limbs. Lesions are typically oval in shape and up to 20 cm in size, and begin as a dark pink color which slowly fades to white in the center, retaining a light pink or purple border. Older lesions may become brown in color. Lesions are typically smooth and hair-free, and do not sweat.

In addition, morphea may present in various other forms, including superficial Morphea (occurs in women of middle-age, presents as symmetrical dark pink lesions in skin folds), linear scleroderma (occurs in children, consists of long, narrow lesions on limbs), en coup de sabre (linear scleroderma occurring on the scalp/temple, accompanied by permanent alopecia), generalized morphea (rare, widespread thickening over the torso), pansclerotic disabling morphea (occurs in children, widespread induration of skin and muscle), and atrophoderma of pierini and pasini (affects subcutaneous tissue, results in depressions on the skin.

The cause of morphea is unknown, though it has been shown to appear after other conditions in some cases. These conditions include injury, Tick bites, viral infection, autoimmune disorders, and pregnancy. The condition may develop in anyone, regardless of age, gender or ethnic group. The condition may persist for years in some cases, and may cause varying deformities, depending on the type of the condition present.

Differential Diagnosis (Other conditions with similar appearance)
Amyloidosis, Primary Systemic
Nephrogenic fibrosing dermopathy
Niemann-Pick Disease
Eosinophilia-Myalgia Syndrome
POEMS Syndrome

    Key Points
    *Diagnosis based on the characteristic appearance of the affected area
    *Skin biopsy will be performed to confirm diagnosis and rule out other conditions, along with imaging tests to determine the extent of the condition

    Morphea is typically diagnosed based on the characteristic appearance of the affected area. A skin biopsy will be performed to confirm the diagnosis and to rule out similar appearing conditions. Imaging tests may be recommended to determine the extent of the condition.

    *No specific, effective therapy for the condition has been found.
    *Various treatments may relieve symptoms

    There is no specific, effective therapy for morphea. However, various treatments are available which may assist in relieving symptoms, including medications such as methotrexate, steroids, antibiotics, ciclosporin, calcipotriol, colchicines, pentoxifylline, penicillamine, and diphenylhydantoin. Procedures such as intralesional steroid Injections, and photo- or photochemotherapy have also proven to be somewhat effective.

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