Introduction: – Morphea, also known as “localized scleroderma”, or “circumscribed scleroderma”, involves isolated patches of hardened skin with no internal organ involvement.
Signs and symptoms:-
Frontal linear scleroderma
Morphea is most often presents as mauls or plaques a few centimeters in diameter, but also may occur as bands or in guttate lesions or nodules.
Morphea is a thickening and hardening of the skin and subcutaneous tissues from excessive collagen deposition. Morphea includes specific conditions ranging from very small plaques only involving the skin to widespread disease causing functional and cosmetic deformities. Morphea discriminates from systemic sclerosis by its supposed lack of internal organ involvement. . This classification scheme does not include the mixed form of morphed in which different morphologies of skin lesions are present in the same individual. Up to 15% of morphed patients may fall into this previously unrecognized category.
Physicians and scientists do not know what causes morphed. Case reports and observational studies suggest there is a higher frequency of family history of autoimmune diseases in patients with morphed. Tests for auto antibodies associated with morphed have shown results in higher frequencies of anti-hailstone and anti-topoisomerase Imia antibodies. Case reports of morphed co-existing with other systemic autoimmune diseases such as primary billiard cirrhosis, vitiligo, and systemic lupus erythematosus lend support to morph as an autoimmune disease.
Throughout the years, many different treatments have been tried for morphed including topical, intra-lesional, and systemic corticosteroids. Antimalarials such as hydroxychloroquine or chloroquine have been used. Other immunomodulators such as methotrexate, topical tacrolimus, and penicillamine have been tried. Some have tried prescription vitamin-D with success. Ultraviolet a (UVA) light, with or without psoralens have also been tried. UVA-1, a more specific wavelength of UVA light, is able to penetrate the deeper portions of the skin and thus, thought to soften the plaques in morphed by acting in two fashions:
• 1) By causing a systemic immunosuppressant from UV light.
• 2) By inducing enzymes that naturally degrade the collagen matrix in the skin as part of natural sun-aging of the skin.
As with all of these treatments for morphed, the difficulty in assessing outcomes in an objective way has limited the interpretation of most studies involving these treatment modalities.
Epidemiology:-Morphea is a form of scleroderma that is more common in women than men, in a ratio 3:1 Morphea occurs in childhood as well as in adult life.