Morphea is a rare type of scleroderma — a chronic disease that affects the skin, connective tissue, and internal organs. It causes painless, discolored patches to form on the skin. Different types of morphea exist, each with varying symptoms. The lesions can form all over the body Because the condition is so rare, there is a notable lack of research and much remains unknown.
Symptoms
Morphea symptoms vary depending on the condition’s classification and severity. Some of the most common signs include:
Red or purple-colored skin patches with oval shapes; usually on the back, chest, or stomach
Patches with lighter or fully white centers
Longer, linear patches on the arms, legs, forehead, and scalp
Affected skin gradually becomes firm, thick, dry, and shiny
Symptoms improve or worsen over time and may even disappear for a period.
Causes
Experts do not fully understand the underlying causes of morphea. They often draw theories of its mechanisms from studies of autoimmune diseases, which usually occur alongside morphea. These conditions include systemic sclerosis, vitiligo, and systemic lupus erythematosus. Factors such as genetics, vascular dysfunction, and autoimmunity likely play a role in morphea. Some researchers believe environmental factors like infections or skin trauma also contribute.
Risk Factors
Medical experts have identified a few risk factors that affect a person’s risk of developing morphea. White people are more likely to have the condition than other ethnicities. Females are three times more likely to have morphea than males. While morphea can affect a person of any age, it usually appears between the ages of two and 14 or in the mid-40s. People with a family history of autoimmune diseases are more likely to have morphea, as well.
Diagnosis
A doctor can diagnose morphea with a physical examination of the skin and asking about present symptoms. In some cases, a skin biopsy may be necessary to reveal potential changes in the skin. To rule out other conditions like systemic sclerosis, doctors may use blood tests or refer to a specialist. As part of the diagnostic process, physicians will often classify a patient’s morphea.
Classification
Researchers and medical experts recognize several classifications for morphea:
Generalized morphea: widespread plaques and changes in skin pigmentation; associations with muscle wasting
Morphea-lichen sclerosis et atrophicus overlap: lesions of both morphea and another inflammatory skin condition called lichen sclerosis et atrophicus
Morphea profunda: affects deep subcutaneous tissue
Pansclerotic morphea: lesions in many areas that limit joint motion
Linear morphea: localized patches causing lines of thickened skin
Frontal linear morphea: linear patches on the scalp
Atrophoderma of Pasini and Pierini: large, oval-shaped lesions with sharp borders; higher collagen levels; lesions are smooth
Complications
Depending on the type and stage, morphea can have several complications. The lesions can cause self-esteem or body image issues, especially if they are in prominent locations. Pansclerotic morphea can cause movement issues affecting everyday actions. Over time, hair and sweat glands may vanish in the affected areas. Children with morphea can have permanent eye damage.
Treatment
The treatment path for morphea focuses on managing symptoms and varies depending on the type of morphea and the affected area. An active disease that has been present for less than three months responds the best to treatment. Topical medications and phototherapy work for most adults with morphea. Systemic therapies with stronger medications are necessary in some cases. People at risk of physical limitations, such as those with pansclerotic morphea, may undergo physical therapy.
Lifestyle and Home Remedies
Uncomplicated and localized cases of morphea may not require medical intervention and are manageable with a few lifestyle changes and home remedies. Often, these instances resolve themselves. Moisturizers can help soften the affected skin. Avoid long, hot showers or baths, because they can dry the skin and lesions. Many people choose to seek counseling or support during outbreaks.
Prognosis
Morphea is usually benign and rarely becomes a more serious issue. In most cases, the lesions are superficial and will resolve with time. More serious classifications of morphea persist longer but do usually improve. However, these types of condition can sometimes cause serious, long-term damage, especially in children. Substantial symptoms may include significant skin changes affecting the face, limb-length discrepancies, and physical disabilities.
Epidemiology
Morphea is a rare condition, affecting only two to four people out of 100,000. However, it is possible that this number is underreported as there are no studies properly assessing the incidence and prevalence. Additionally, people with smaller lesions may never visit a doctor, leading to less accurate incidence numbers.