Morphea

Diagnosis: Morphea

Morphea

Clinical Presentation

Morphea

Clinical History

Submitted by Ellie Goulding MD. Originally posted January 23, 2017.

Treatment

See case discussion.

Differential Diagnosis

• Systemic sclerosis (scleroderma) • Lichen sclerosus • Radiation dermatitis • Nephrogenic systemic fibrosis • Eosinophilic fasciitis • Vitiligo (early morphea) • Lipodermatosclerosis

Key Learnings

• Localized scleroderma — fibrosis confined to skin ± subcutaneous tissue • Does NOT typically progress to systemic sclerosis (different disease) • "Lilac ring" sign: violaceous border indicates active, inflammatory phase • En coup de sabre: linear morphea of the forehead — Parry-Romberg syndrome overlap • Histology: thickened, homogenized collagen bundles replacing subcutaneous fat • Active disease: positive anti-ssDNA, elevated eosinophils, elevated ESR • Linear morphea in children can affect bone growth if crossing joints

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