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Genetic and Rare Diseases Information Center (GARD)

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Localized scleroderma


Other Names for this Disease

  • Scleroderma, localized
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Your Question

I have been diagnosed with morphea. Can you please provide me with patient-friendly information about this disease?

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What is localized scleroderma?

Localized scleroderma is characterized by thickening of the skin from excessive collagen deposits. Collagen is a protein normally present in our skin that provides structural support. However, when too much collagen is made, the skin becomes stiff and hard.[1] Localized types of scleroderma are those limited to the skin and related tissues and, in some cases, the muscle below. Internal organs are not affected by localized scleroderma, and localized scleroderma can never progress to the systemic form of the disease. Often, localized conditions improve or go away on their own over time, but the skin changes and damage that occur when the disease is active can be permanent. For some people, localized scleroderma is serious and disabling.[2]

There are two generally recognized types of localized scleroderma: morphea and linear.[2]

 

Last updated: 4/3/2012

What causes morphea?

The exact cause of morphea is unknown.[1][3] It is not infectious. It is not hereditary, though, similar problems may present in other family members.[1] It's believed that a reaction of the immune system plays a role in the development of this rare condition.[1][3] Experts have explored a possible connection between morphea and infection, such as measles or chickenpox, but recent research doesn't support this theory. Other factors that may be associated with the onset of morphea include radiation therapy or repeated trauma to the affected area.[1] 

Last updated: 1/28/2010

What symptoms are associated with morphea?

Signs and symptoms of morphea, include:[3]

  • Hardening of the skin.
  • Thickening of the skin.
  • Discoloration of the affected skin to look lighter or darker than the surrounding area. 

The first signs of the disease are reddish patches of skin that thicken into firm, oval-shaped areas. The center of each patch becomes ivory colored with violet borders. These patches sweat very little and have little hair growth. Patches appear most often on the chest, stomach, and back. Sometimes they appear on the face, arms, and legs.[2]

Morphea usually affects only the uppermost layers of your skin, but in some cases may involve fatty or connective tissue below your skin.[3]

Morphea can be either localized or generalized. Localized morphea limits itself to one or several patches, ranging in size from a half-inch to 12 inches in diameter. The condition sometimes appears on areas treated by radiation therapy. Some people have both morphea and linear scleroderma (which is characterized by a single line or band of thickened and/or abnormally colored skin). The disease is referred to as generalized morphea when the skin patches become very hard and dark and spread over larger areas of the body.[2]

Last updated: 1/21/2010

How might morphea be treated?

There is no cure for morphea. Treatment is aimed at controlling the signs and symptoms and slowing the spread of the disease. The earlier treatment is started, the more effective it is. The precise treatment depends on the extent and severity of the condition, but may include:[3]

  • Calcipotriene cream (Dovonex). This synthetic form of vitamin D may help lessen the effecvts of morphea.
  • Corticosteroids. A doctor may prescribe these medications early in the course of treatment, to reduce inflammation and prevent thickening of the collagen. They can be taken either orally or topically or both.
  • Antimalarial drugs. Medications such as hydroxychloroquine (Plaquenil) or chloroquine (Aralen) may help reduce inflammation and slow the progress of the disease.
  • Immunosuppressive medications. The doctor may prescribe these drugs (methotrexate or cyclosporine) to control the immune system and reduce inflammation.
  • Physical therapy. This type of treatment uses stretching, strengthening and range-of-motion exercises to improve the mobility of the joints.
  • Light therapy. This approach uses ultraviolet light to improve the appearance of the skin. It works best when initiated soon after skin changes appear.   

In addition, individuals with morphea are encouraged to apply moisturizer frequently, apply sunscreen before going outdoors, use humidifiers to moisten the air indoors, take warm, not hot, baths and showers, and avoid harsh soaps and household cleaners.[4]

More detailed information about the treatment of morphea can be accessed through eMedicine.

Last updated: 6/23/2011

What is the prognosis for individuals with morphea?

Most patients develop only one or two patches of thickening that are frequently darker or lighter than the surrounding skin. A yellow discoloration may also occur.[1] Although morphea generally fades out in 3 to 5 years, the changes in skin color may last for years, in spite of improvement and softening of the skin.[2][1]  Some patients continue to develop new patches and essentially go on to develop generalized morphea.[1] Rarely, muscle weakness may occur.[2] 
Last updated: 6/23/2011

Who can I contact to learn more about morphea and other forms of localized scleroderma?

You can learn more about morphea and other forms of localized scleroderma by visiting the following link from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of NIH.
http://www.niams.nih.gov/hi/topics/scleroderma/scleroderma.htm#2

Additionally, NIAMS offers printed materials on scleroderma. We recommend calling the toll-free number below to request a copy of this information.

National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse
National Institutes of Health
1 AMS Circle
Bethesda, Maryland 20892-3675
Toll free: 877-22-NIAMS
Telephone: 301-495-4484
TTY: 301-565-2966
Fax: 301-718-6366
Email: niamsinfo@mail.nih.gov
Web site: http://www.niams.nih.gov/hi/index.htm

More information on scleroderma can be found at the following link from MEDLINEplus, the National Library of Medicine Web site designed to help you research your health questions.
http://www.nlm.nih.gov/medlineplus/scleroderma.html
Last updated: 9/12/2013

How can I locate research for morphea?

ClinicalTrials.gov lists trials that are studying or have studied morphea. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

You can also contact the Patient Recruitment and Public Liaison (PRPL) Office at the National Institutes of Health (NIH). We recommend calling the toll-free number listed below to speak with a specialist, who can help you determine if you are eligible for any clinical trials.  

Patient Recruitment and Public Liaison Office
NIH Clinical Center
Bethesda, Maryland 20892-2655
Toll-free: 800-411-1222
Fax: 301-480-9793
Email: prpl@mail.cc.nih.gov
Web site:  http://clinicalcenter.nih.gov/

If you are interested in enrolling in a clinical trial, you can find helpful general information on clinical trials at the following ClinicalTrials.gov Web page.
http://clinicaltrials.gov/ct2/info/understand

A tutorial about clinical trials that can also help answer your questions can be found at the following link from the National Library of Medicine:
http://www.nlm.nih.gov/medlineplus/tutorials/cancerclinicaltrials/htm/lesson.htm

Resources on many charitable or special-fare flights to research and treatment sites and low-cost hospitality accommodations for outpatients and family members, as well as ambulance services, are listed on the Web site of the Office of Rare Diseases (ORD), part of the National Institutes of Health.
http://rarediseases.info.nih.gov/Resources.aspx?PageID=8

Last updated: 6/23/2011

How can I find journal articles on morphea?

PubMed lists journal articles that discuss morphea. Click on the link to go to PubMed and review citations to these articles.
Last updated: 9/12/2013

References
Other Names for this Disease
  • Scleroderma, localized
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.