Last updated: June 2024
Also known as: Localised scleroderma
What is morphoea?
Morphoea is a disorder of the skin collagen. Morphoea is characterised by thickening of the skin. It does not usually have any internal involvement.
Who gets morphoea?
It can occur at any age but most commonly occurs in young adults and children. Females are more likely than males to develop morphea (ratio 4:1). 1
Caucasians are more commonly affected by morphea, followed by individuals who are Hispanic and Latin American.
What causes morphoea?
The cause of morphoea is not known. However, autoimmune and environmental may be contributing factors.
Some individuals may develop morphoea after an infection such as measles, varicella and Borrelia burgdorferi. Cases of morphea have been reported after vaccinations. 2
What does morphoea look like?
The excessive accumulation of collagen in the skin makes the affected areas look and feel thickened and hard. The skin over the area becomes attached and unable to be pinched. At first, morphoea presents as a pale, ivory-coloured spot with a surrounding red or purple border.
Single or multiple oval hard lesions (plaques) appear more commonly on the trunk and extremities.
Less commonly, the affected areas can be widespread (generalised) or affect deeper structures (such as fat, fascia, muscle or bone). Linear morphoea, a particular form of the condition, presents as a very thick band that produces contractures in fingers, arms or joints or affects important structures such as the particular presentation of “en coup de sabre” which gets its name from its similarity to a sabre wound to the face, forehead and scalp.
How is morphoea diagnosed?
The condition is usually diagnosed clinically.
A tissue sample from the affected area is often taken to confirm the diagnosis. There are no specific blood tests available that can help to confirm the diagnosis, but they can be used to rule out an underlying medical condition.
How is morphoea treated?
Treatment options will vary depending on the individual and their needs.
The aim of treatment is to reduce inflammation and avoid deposits of collagen.
Some commonly used treatments may include topical or systemic steroids, topical vitamin D analogues, oral methotrexate, intralesional therapy, phototherapy or some potent systemic immunosuppressants such as cyclosphosphamine.
Severe or complicated cases may require a combination of therapy and referral to other specialties (such as surgery and physiotherapy).
What is the likely outcome of morphoea?
Most cases of morphoea heal spontaneously, leaving a scar. However, it can follow a protracted course, which can be relapsing and remitting or chronically active.
- Papara C, De Luca DA, Bieber K, Vorobyev A, Ludwig RJ. Morphea: The 2023 update. Front Med (Lausanne). 2023 Feb 13;10:1108623. doi: 10.3389/fmed.2023.1108623. PMID: 36860340; PMCID: PMC9969991.
- Metin Z, Celepli P. A case of morphea following the COVID-19 mRNA vaccine: on the basis of viral spike proteins. Int J Dermatol 2022;61:639-41. https://doi.org/10.1111/ijd.16062
| Dr Giuliana Carlos and Dr Pablo Fernández-Peñas | June 2024 |
| Dr Giuliana Carlos and Dr Pablo Fernández-Peñas | June 2015 |