What is morphea?
Morphea is a skin condition that involves a patch or patches of discolored or hardened skin on the face, neck, hands, torso, or feet. The condition is rare and thought to affect less than 3 out of 100,000 people.
Morphea predominately affects your skin. It doesn’t involve your internal organs. In most cases, it resolves on its own, but you can experience a relapse.
More severe forms can lead to cosmetic deformities, and it occasionally affects the muscle, joints, or bone.
Pictures of morphea
What are the symptoms of morphea?
In general, morphea causes discolored, thickened patches of skin that are oval in shape. The outer edge of the lesion may be lilac, and the patch itself is usually reddish in color. It gradually becomes white or yellow in color toward the center of the oval.
The exact symptoms and the severity of those symptoms depends on the type of morphea:
This is the most common type. People with plaque-type morphea have three or four oval lesions. The lesions are painless, but might itch.
Generalized plaque morphea
This involves multiple widespread lesions that are larger. Generalized morphea can affect deeper tissues, which might lead to disfigurement. The lesions can also join together.
This is a rapidly progressive type of morphea with many plaques that can cover almost your entire body. It spares hands and feet. This type needs the most aggressive treatment.
Linear morphea features a single band of thickened, discolored skin. Usually, the indented band runs down an arm or leg, but it might also extend down your forehead. This is referred to as en coup de sabre because it makes the skin look as though it’s been struck by a sword.
Linear morphea is the most common type of morphea found in school-aged children. The lesions may extend to the tissue under their skin, even to their muscles and bones, leading to deformities. If linear morphea occurs on their face, it might cause issues with their eyes or alignment of their teeth.
What causes morphea?
The exact cause of morphea isn’t yet known. It’s thought to be an immune disorder, meaning that the immune system is attacking the skin. The collagen-producing cells might become overactive and overproduce collagen.
Collagen is a protein normally found in skin that helps provide structural support. With too much collagen, your skin becomes hard. Morphea may be triggered by radiation therapy, repeated trauma to your skin, environmental exposure, or an infection.
Morphea isn’t contagious, so you can’t get it from or spread it by touching someone else.
Who is at risk for morphea?
Morphea is more common in women than in men. It can occur in both children and adults, and is usually diagnosed in school-aged children between the ages of 2 and 14 or in adults in their 50s. Morphea is more common in people of European descent.
How is morphea diagnosed?
If you have unexplained hard or discolored patches of skin, your doctor may refer you to a dermatologist (a doctor who specializes in skin problems) or a rheumatologist (a doctor who specializes in diseases of the joints, bones, and muscles).
Your doctor is likely to ask you questions about your symptoms, such as when you first started noticing changes in your skin, if you’ve done anything to treat yourself, and if you have any other symptoms. They’ll ask for a family health history and about any recent illnesses you’ve had and any medications you’re taking.
There is no test for diagnosing morphea. Your doctor will examine your skin and, though not usually necessary, might take a small sample to have analyzed by a lab. This is called a skin biopsy.
They may also order some tests to help distinguish morphea from something called systemic scleroderma. This type of scleroderma is similar to morphea at first. But it can later affect internal organs and requires more aggressive treatment.
Complications of morphea
Morphea with deep lesions, lesions on your face or neck, or widespread lesions can lead to:
- restricted joint mobility
- joint pain
- cosmetic deformities
- permanent eye damage in children
- hair loss
Often people with morphea also have genital lichen sclerosis, which can cause itching and burning and changes to your skin. It’s important to tell your doctor about these symptoms if you have morphea.
How is morphea treated?
There is no cure for morphea. Type of treatment depends on the type of morphea and how severe it is. Current treatment is aimed at controlling symptoms until the morphea goes away on its own, typically within five years. For more limited morphea , treatment is considered optional and may include:
- phototherapy (light therapy using artificial ultraviolet light)
- a vitamin D cream called calcipotriene (Dovonex)
For more generalized or quickly progressive types of morphea, doctors may recommend oral medications such as methotrexate or high-dose steroids.
At home, you can apply moisturizers to help soften your skin. Try to avoid long, hot showers or anything that can dry out your skin. Other treatments include:
- applying sunscreen before going outside
- avoiding harsh soaps and chemicals on your skin
- using a humidifier to add moisture to the air, particularly during winter
- exercising regularly to improve blood circulation
In more severe cases, including lesions that cause disfigurement or joint problems, more aggressive therapy might be needed to help fight inflammation and prevent deformities, including:
- physical therapy
Children with morphea on their head and neck should see an ophthalmologist, a specialist in eye problems, for regular eye exams.
What is the outlook?
Most cases of morphea slowly go away on their own over time and don’t alter a person’s life expectancy. On average, a lesion lasts three to five years, but discoloration might persist for a few more years. Occasionally, people will develop new lesions later on.
Linear and deep morphea can interfere with the growth of children and lead to further problems, including differences in limb length, stiff and weak limbs, eye damage, and even death, but this is considered quite rare.