[Localized scleroderma (morphea)]

Author(s): Bono W, Dupin N

Affiliation(s): Service de Medecine Interne, Hopital Cochin, Centre de Reference pour les Vascularites Necrosantes et la Sclerodermie Systemique, AP-HP et Universite Paris-Descartes, Faculte de Medecine Paris-Descartes, Paris.

Publication date & source: 2006-12, Presse Med., 35(12 Pt 2):1923-8.

Publication type: Comparative Study; English Abstract; Review

DEFINITION AND FREQUENCY: Localized scleroderma, also known as morphea, is a sclerotic condition limited to the skin. The specific clinical entity depends on the extent, linear disposition and depth of the lesions. Morphea is ten times more prevalent than systemic sclerosis, and its prognosis is generally good: superficial forms resolve within 3 years. NO SYSTEMIC INVOLVEMENT: In the absence of symptoms, examinations to detect systemic involvement are purposeless. Plaque morphea is the most frequent clinical presentation. Serious manifestations include extensive morphea that may involve the entire skin or linear forms, especially in children, where they may be severe, especially on the face. There are no immunological markers clearly associated with morphea and no causative agents have been implicated in its pathogenesis, although sclerodermiform dermatitis is reported to be associated with some drugs and toxic agents. TREATMENT: There is no consensual treatment for morphea. Treatment should be decided according to severity and extent of lesions. Limited lesions may be treated with local steroids such as class IV corticosteroids. Systemic treatment (methotrexate) should be discussed in extensive and linear forms when there is a risk of functional or esthetic complications.