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Morphea

Todd Kettering, DO, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • A benign inflammatory skin disorder leading to excessive collagen deposition with thickening and sclerosis of the skin and subcutaneous tissues with characteristic plaque formation

    • ...

DIAGNOSIS

HISTORY

  • Patient describes slowly progressive skin changes over months. Coin-sized lesions slowly enlarge over weeks to months.

  • Rarely, the lesions can cause some discomfort.

  • Usually, there are ...

TREATMENT

MEDICATION

First Line

  • Active lesions can respond to treatment, inactive lesions cannot. Relapse rates present in 25–35% (3)[B].

  • Superficial subtypes generally respond to topical treatments.

    • Re...

ONGOING CARE

Lesions may self-resolve over 3 to 5 years. Recommend evaluation of joints, eyes, and CNS for involvement throughout course of active disease. Many patients with plaque form will progress...

REFERENCES

1
Mertens J, Seyger M, Thurlings R, et al. Morphea and eosinophilic fasciitis: an update. Am J Clin Dermatol.  2017;18(4):491–512. [View Abstract on OvidMedline]
2
Careta MF, Romiti R. Lo...

ADDITIONAL READING

  • Fett N, Werth VP. Update on morphea: part I. Epidemiology, clinical presentation, and pathogenesis. J Am Acad Dermatol.  2011;64(2):217–230. [View Abstract on OvidMedline]

  • Li SC...

CODES

ICD10

  • L94.0 Localized scleroderma [morphea]

  • L94.1 Linear scleroderma

ICD9

701.0 Circumscribed scleroderma 

SNOMED

  • 201049004 Morphea (disorder)

  • 128458002 plaque morphea (disorder)

  • 7513007 Generalized mor...

CLINICAL PEARLS

  • Morphea lesions are well-circumscribed plaques that are firm, waxy, and have an ivory color. They are usually multiple, start small, and may slowly enlarge over time. Presence on the t...

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