Morphea is a term used to describe the skin symptoms of localized scleroderma, although the terms sometimes are used interchangeably.

While it can occur in all age groups, it is more common among adults. Women develop morphea more frequently than men. 

Subtypes of morphea

There are several subtypes of morphea including plaque morphea, generalized morphea, deep morphea, and bullous morphea. All types of morphea change with time. Initially, there may be more and bigger patches, but those soften and darken over time, with each patch lasting about three to five years.

What does morphea look like?

Morphea is characterized by limited, round or oval-shaped areas of hard and shiny skin that may itch, but usually are not painful. Early in the disease, there may be a “purple ring” around the patch before it turns white and eventually brown. Morphea can occur in one or more areas of the body and usually is found around the torso. The face is generally spared.

In plaque morphea there usually is only one patch, while in generalized morphea these patches are more widespread and may merge over time. Patients with only one or two morphea patches rarely progress to having generalized morphea. But when it happens, this transformation is more common in women. Those with bullous morphea have blisters on their patches. Patients with deep morphea may experience thickening of the tissue and muscles underlying the morphea patches, although this also may happen with other subtypes of localized scleroderma.

Diagnosis

An examination of the skin patches usually is enough for physicians to diagnose the subtypes of morphea. Occasionally, a skin biopsy may be done to confirm the diagnosis. Blood tests or imaging studies like magnetic resonance imaging (MRI) are rarely necessary.

Treatment and prognosis

Morphea is not a life-threatening disease. Treatments used for symptom control include phototherapy, vitamin D creams, or corticosteroids.

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