Overview
Morphea is a rare condition characterized by painless, discolored patches on the skin. These patches usually appear on the belly, chest, or back but can also appear on the face, arms, and legs. Over time, the patches may become firm, dry, and smooth. Morphea primarily affects the outer layers of the skin, but some forms also affect deeper tissues and can restrict joint movement. The condition often improves on its own over time, but recurrences are common. Medications and therapies are available to help treat skin discoloration and other effects. The exact cause of morphea is unknown, but it may result from an abnormal immune system reaction or be triggered by factors such as injury, medications, or infections.
Understanding the disease
Symptoms
The symptoms of morphea may include reddish or purplish oval patches of skin on the belly, chest, or back, which gradually develop a lighter or whitish center. Linear patches, particularly on the arms or legs and possibly the forehead or scalp, may also occur. Morphea usually affects the outer layers of the skin, but some forms may also affect deeper tissues, causing movement problems in the joints. Other possible symptoms include itchiness, numbness, tingling, burning, or weakness in the hands, feet, arms, or legs; a feeling of fullness after eating, bloating, or pain in the left upper abdomen due to an enlarged spleen; unusual bleeding; painful swelling of one joint, often the big toe; and shortness of breath and difficulty breathing when lying down. It is important to note that these symptoms may vary depending on the type and stage of the condition.
Risk Factors
Being white and female increases the risk of developing morphea. The condition can affect people of any age, but it usually appears between the ages of 2 and 14 or in the mid-40s. A family history of morphea and other autoimmune diseases can also play a role in the development of the condition.
Development
Morphea is a rare condition that causes discolored patches on the skin. The exact cause is unknown, but it is believed to be related to an abnormal reaction of the immune system. Morphea may be triggered by various factors such as injury to the affected area, medications, chemical toxins, infections, or radiation therapy, particularly in people who are at an increased risk of developing the condition. The symptoms of morphea vary depending on the type and stage of the condition. Common symptoms include reddish or purplish oval patches of skin, patches that gradually develop a lighter or whitish center, linear patches, especially on the arms or legs and possibly the forehead or scalp, and over time, the patches may become firm, dry, and smooth. Morphea tends to affect only the outer layers of the skin, but some forms of the condition also affect deeper tissues and may restrict movement in the joints. Morphea usually improves on its own over time, but recurrences are common. Medications and therapies are available to help treat the skin discoloration and other effects. Early diagnosis and treatment may help slow the development of new patches and allow your doctor to identify and treat complications before they worsen.
Assessment and Diagnosis
Triage
You should see a doctor if you notice reddish patches of hardening or thickening skin. Early diagnosis and treatment may help slow the development of new patches and allow your doctor to identify and treat complications before they worsen.
Diagnosis
To diagnose morphea, your doctor may start by examining the affected skin and asking about your signs and symptoms. They might also take a small sample of your skin (skin biopsy) for examination in a laboratory to reveal changes in your skin, such as thickening of a protein (collagen) in the second layer of skin (dermis). Your doctor may distinguish morphea from systemic scleroderma and other conditions by having you undergo a blood test or referring you to a specialist in skin disorders (dermatologist) or diseases of the joints, bones, and muscles (rheumatologist). If your child has head and neck morphea, regular comprehensive eye exams are recommended to check for unnoticeable yet irreversible eye damage.
Management and Treatment
Treatment
Treatments for morphea generally focus on managing the symptoms and addressing any complications. There is no cure for morphea, but various treatments can help improve the appearance of affected skin and alleviate discomfort. Some possible treatments for morphea include:
- Topical corticosteroids: These creams or ointments can help reduce inflammation and redness in the affected areas. They may be prescribed for milder cases of morphea.
- Phototherapy: This treatment involves exposure to ultraviolet B (UVB) light, which can help reduce inflammation and slow the progression of the condition. Phototherapy may be recommended for more severe cases or if topical corticosteroids are not effective.
- Immunosuppressants: In some cases, immunosuppressant medications may be prescribed to help regulate the immune system's response. These medications can help prevent new patches from forming and may help reduce existing patches over time.
- Compression garments: For morphea that affects the arms or legs, wearing compression garments may help improve blood flow and prevent stiffness or contractions in the affected joints.
- Surgical excision: In cases where morphea causes significant disfigurement or functional impairment, surgical excision may be considered. This involves removing the affected skin and repairing the underlying tissue.
- Wound care: For people with morphea who experience skin damage, such as loss of hair and sweat glands or eye damage, wound care may be necessary to prevent infection and promote healing. It is important to consult a healthcare professional for an accurate diagnosis and personalized treatment plan. They can help determine the most appropriate treatment options based on the type, stage, and severity of the condition.