Morphea is a rare type of skin condition that results in areas of skin becoming hardened and discolored.
These plaques can occur on several areas, including the face and neck, hands, feet, back, and chest. Morphea may also appear on the legs and arms. It affects fewer than 3 out of every 100,000 people.
Morphea is usually painless and will disappear on its own, but this may take several years. The condition can sometimes return, even after it has gone away. It seems to be particularly problematic when it affects cosmetically sensitive areas, the face, and the joints.
Most health professionals consider morphea to be an unusual autoimmune condition in which immune system dysfunction occurs and causes characteristic skin symptoms.
However, the exact cause of the condition is unclear and remains unknown.
When morphea occurs, the collagen-producing cells overproduce collagen, causing it to build up and the skin to harden.
There is much to learn about morphea, but its onset could be related to:
- repeated trauma to the skin
- aggressive treatments, such as radiation therapy
- an infection
- skin damage caused by environmental exposure
Morphea is not a contagious condition and cannot spread from person to person.
The symptoms of morphea differ depending on the stage and severity of the condition.
Some common signs and symptoms include:
- patches of reddish or lilac skin, most commonly on the torso
- linear patches of discolored skin on the arms or legs
- patches of skin that gradually turn lighter or have a whitish center
- patches of skin that gradually harden and have a thick, shiny appearance
- hair loss in the affected area
- loss of sweat glands in the affected area
The appearance of morphea usually only affects the skin and its underlying tissue, although it can also affect the bone and muscle.
There are several types of morphea:
Plaque morphea usually consists of limited oval lesions that appear on the skin. The lesions are typically painless but may become itchy.
Plaque morphea is the most common type of morphea.
Generalized plaque morphea
Generalized plaque morphea is more widespread than plaque morphea. A person with generalized plaque morphea will have more lesions over a greater area of skin. It can also affect deeper tissues, possibly leading to cosmetic disfigurement and lesions joining together.
This form of morphea is rare and tends to require aggressive treatment. Pansclerotic morphea occurs when the lesions cover almost all of the body. It progresses quickly, and medical intervention is necessary to try to manage it. It usually starts in children.
Linear morphea usually occurs on the arms or legs and appears as a single band of thick, discolored skin. The lesions can cross joints and extend to the tissue under the skin, as well as the muscles and bone. This can lead to deformities.
Sometimes, linear morphea appears as a line on the forehead, which can cause problems with eyesight or lead to neurological problems. This type of morphea is more likely to affect school-aged children.
If a person notices any skin changes — such as the development of hard, thickening, or purple-reddish patches — it is essential to seek medical attention as soon as possible.
A doctor may make a referral to a dermatologist, or a doctor who specializes in skin conditions. They may also consult a rheumatologist, or a doctor who specializes in joints, bones, and muscles.
Dermatologists can usually diagnose the condition by performing a physical exam, but they will likely confirm it by carrying out a skin biopsy.
Morphea is more likely to occur in women than in men.
Although it can affect both adults and children, doctors usually diagnose morphea in children aged 2–14 and in adults in their mid-40s.
Complications of morphea include:
- restricted joint mobility
- pain in the joints
- cosmetic abnormalities, which may lead to low self-esteem
- permanent eye problems or neurological involvement, though this is rare
- hair loss in the affected area
- genital lichen sclerosis, an associated condition that can cause itching and burning
Although there is currently no cure for morphea, there are various treatments available that can help prevent it spreading and causing scarring and complications.
Treatment depends on the severity and type of morphea. Some options include:
- Phototherapy. This is a generic term that refers to light therapy for skin conditions. Practitioners commonly perform phototherapy using the ultraviolet A wavelength for morphea treatment.
- Calcipotriene (Dovonex). This is a type of vitamin D cream.
- Topical or intralesional steroids.
In some cases, a doctor may prescribe oral medications, such as methotrexate or corticosteroids. They may also suggest physcial therapy.
If a child has morphea on the head, they may need to make regular visits to an eye doctor and a neurologist.
Morphea is a rare skin condition that will usually only affect the appearance of the skin and will go away without treatment.
However, in more severe cases, morphea can cause mobility issues or deformities.
In children, morphea can cause eye damage and problems with limb growth and movement.
Anyone who thinks they may have morphea should seek medical advice to ensure that they get appropriate treatment and recommendations on how to manage the condition.