Morphea: When to see a doctor and avoid complications

What is Morphea

Morphea is a rare painless skin condition, a localized form of scleroderma. It is a hardening and thickening of the skin and subcutaneous tissues resulting from excessive deposition of collagen. This causes patches of reddish skin that thicken into firm, oval shaped areas.

A lighter centre may develop in the centre of each patch and linear patches can occur especially on the arms and legs. The patches sweat less than unaffected zones and, over time, the area may lose hair. Morphea usually only affects the upper skin layers but sometimes it may migrate to tissues below the skin or interfere with joint movement.

The condition occurs most often on the chest, abdomen, stomach and back, and sometimes on the arms, legs and face. The morphea can be localized and limited to one or several patches, or spread more widely over the body.

Women are more likely to develop morphea than men but the condition can arise at any age – but most commonly between the ages of two and fourteen or in the mid forties. It is also more prevalent amongst Caucasians.

The causes of Morphea

Physicians do not know the underlying cause of morphea but it may be triggered by a recent infection such as chickenpox or measles, radiation therapy, by an abnormal immune response or repeated trauma to the affected zone.

It normally goes away without treatment within three to five years, but some patients are left with darkened areas of skin. It can cause muscle weakness but this is rare.

In this case, treatment for Morphea may include corticosteroids, prescription vitamin D creams, or phototherapy.

When to see your Doctor

If you notice hardening or thickening skin in reddish patches, visit you Doctor.

Early diagnosis and treatment may inhibit the development of new patches and allow your Doctor to identify and treat symptoms until it resolves.

Circumscribed morphea which is also called morphea en plaque, is the most common subtype. People usually present with up to three discrete patches on the torso ranging from one centimeter to twenty centimeters in diameter.

Patches on the torso often line in a horizontal direction with an asymmetrical distribution and are more common on the lower trunk such as the hips and around the waist and bra line in women.

When the disease is active, a lilac ring may surround the affected region and as it progresses, sclerosis develops centrally as the lesions expand. Over the months and years, the surface becomes shiny and smooth and ivory colored. The lesions will also destroy the hair follicles and sweat glands.

There is a deep variant of morphea sometimes called subcutaneous morphea or morphea profunda. This involves underlying muscle and subcutaneous fat. It is characterized by ill defined plaques with a “cobblestone” like appearance.

Later in the development of the disease, a depression may develop along the course of a vein or between muscles, or both. These lesions are often highly colored but because of the deeper level of the inflammation, they do not present the color changes which are typical of circumscribed morphea.

Complications

Morphea can cause complications including:

  • Many new patches of discolored and hard skin may appear to merge together – a condition called generalized morphea
  • Children with morphea on the neck and face may experience permanent eye damage
  • Dry eyes are frequently reported due to sclerosis of the eyelids or lacrimal glands.
  • Reflux and various vascular complaints have been reported
  • Fatigue and malaise
  • Linear and deep lesions can also be associated with arthritis and carpal tunnel syndrome

Early diagnosis will avoid complications to occur and that’s why it is important to identify the symptoms and talk to a physician as soon as possible.