Morphea, also known as localized scleroderma, is a thickening and hardening of the skin and subcutaneous tissues from excessive collagen deposition. Morphea includes specific conditions ranging from very small plaques only involving the skin to widespread disease causing functional and cosmetic deformities. Morphea tends to affect only the outermost layers of your skin, with no damage to internal organs. Sometimes, morphea can restrict movement in your joints.
Treatment depends on the severity. With morphea, you may naturally be concerned about your appearance. Your doctor may recommend medications and other treatments to help with your appearance and other symptoms.
Morphea is a form of scleroderma, a term that literally means "hard skin." Symptoms of morphea include:
- Hardening of the skin.
- Thickening of the skin.
- Discoloration of the affected skin to look lighter or darker than the surrounding area. Most people develop one or two oval-shaped patches that start out red, purple (lilac-colored) or yellowish and gradually develop a whitish center. Over time the patches may turn brownish in color and eventually white.
Morphea usually affects only the uppermost layers of your skin, but in some cases may involve fatty or connective tissue below your skin
The exact cause of morphea is unknown. It's believed that a reaction of the immune system plays a role in the development of this rare condition.
Experts have explored a possible connection between morphea and infection, such as measles or chickenpox, but recent research doesn't support this theory. Other factors that may be associated with the onset of morphea include radiation therapy or repeated trauma to the affected area.
When to seek medical advice
If you notice patches of discoloring, hardening or thickening skin, see your doctor. An early diagnosis allows for the most successful treatment of affected skin, may help slow the development of new patches, and allows your doctor to identify and treat complications before they progress.
Tests and diagnosis
A doctor who specializes in skin conditions (dermatologist) may confirm a diagnosis of morphea based on:
- Physical examination. Discoloration combined with skin firmness is a good indicator of morphea. After inspecting your skin and discussing other signs and symptoms you may have, your doctor may recommend taking a tissue sample for analysis.
- Tissue sample. Your doctor may remove a small tissue sample (biopsy) of your affected skin to be examined in the laboratory for abnormalities that allow for diagnosis, such as thickening of the collagen in the second layer of skin (dermis). Collagen is a protein that makes up your connective tissues, including your skin. It helps make your skin elastic and resilient.
The most common complication of morphea is a possible negative effect on your self-esteem and body image if discolored patches of skin appear on your arms, legs and face.
If your face is involved, your skin may appear depressed and discolored. Often only one side of the face is affected, extending from the scalp and forehead to the chin (en coup de sabre). Though your skin will likely soften and become less obviously discolored over time, some discoloration may last for years.
Morphea that affects the arms and legs impairs joint mobility in up to one in five people with the condition. The pain may subside in the following months or years, even if discolored patches of skin remain.
Sometimes new patches of hard, discolored skin appear in such numbers that some may seem to join together. This more extensive condition is called generalized morphea. Rarely, morphea may be part of a more serious condition called progressive systemic scleroderma, which may affect your blood vessels and internal organs
Treatments and drugs
Morphea has no known cure. Treatment of morphea focuses on controlling the signs and symptoms and slowing the spread of the disease. The earlier you begin treatment, the more effective it is. The precise treatment depends on the extent and severity of your condition, but may include:
- Corticosteroids. Your doctor may prescribe these medications early in the course of treatment, to reduce inflammation and prevent thickening of the collagen. They can be taken either orally or topically or both.
- Antimalarial drugs. Medications such as hydroxychloroquine (Plaquenil) or chloroquine (Aralen) may help reduce inflammation and slow the progress of the disease.
- Immunosuppressive medications. Your doctor may prescribe these drugs to control your immune system and reduce inflammation.
- Physical therapy. This type of treatment uses stretching, strengthening and range-of-motion exercises to improve the mobility of your joints.
- Laser treatments, topical creams and chemical peels. These approaches help bring the look of natural color back to affected skin after the inflammation has subsided.
- Plastic surgery. Cosmetic surgery techniques may improve the look of discolored skin in highly visible places.
Lifestyle and home remedies
The sun can darken skin already discolored by morphea, so be sure you wear sunscreen, cover affected skin and avoid direct contact with the sun whenever possible. In addition, use moisturizers to soften and improve the feel of your skin.
If you have morphea in more visible locations, makeup and other topical treatments may help to hide the condition and make your skin appear more natural.
More details: http://www.mayoclinic.com/health/morphea/DS00718