Morphea is a skin condition that results in formation of thickened patches/lesions over the skin. It is also known as localized scleroderma. It mostly affects children and young adults. The patches mostly occur on the back, abdomen, but may also affect the face, arms and the legs of the person. It can either affect the superficial layers of skin as in linear morphea or deeper tissues and bones as in pansclerotic morphea. These patches can be localized or generalized spreading over large areas of the skin. In case of pansclerotic morphea it can lead to restriction of movements of the joints affected.
Is Morphea Life Threatening?
Morphea is a not a life threatening condition as it does not affect the life expectancy of the affected individual. In severe cases; however, it can lead to physical limitations. Most cases of morphea mostly resolve on their own and do not require any kind of treatment. It is the complicated cases involving the underlying bones and tissues that require treatment right away. The exact cause of morphea is not clear, but it might be associated with an abnormal immune response to repeated injury/trauma or an infection. They will usually appear on the skin as reddish patches that are thick and firm and oval shaped with a light center. There can be loss of hair and sweat glands over these affected areas in some time. They mostly affect females more than males. They usually do not lead to any life-threatening complications, but can lead to self-esteem issues especially in young children when they appear on the exposed parts of the skin. In very rare cases, they can cause eye damage and joint restrictions leading to impaired motility.
Management Of Morphea Or Localized Scleroderma
It is important to confirm the diagnosis in order to effectively treat the condition. A physical examination will be done and typical findings suggestive of morphea include deposition of collagen with white cell infiltration. Biopsy of the affected part might be done to reach a conclusive diagnosis.
After the establishment of the diagnosis the treatment is started based on the severity and involvement of the area of the skin. Uncomplicated morphea does not usually require any treatment and can be left as it is. It will resolve on its own in a few years. People who have self esteem issues can undergo treatment in the initial stages of the disease for better response. Drugs can be given to reduce inflammation in the initial stages and also reduce any pain associated with the joints and injuries. After this laser intervention or light therapy can be done to correct the appearance of the skin. When the morphea is deep then physiotherapy might also be needed to be done to ensure maximum movements and prevent contractures and restriction of movements in the long run.
In severe cases treatment is aimed at preventing or controlling inflammation first then later the measures to diminish scars can be taken. The use of local steroids and anti-inflammatory creams can be used such as tacrolimus and proctopic cream. In such cases UV phototherapy is also beneficial. Other treatment options that are being tried nowadays include the combination of anti-inflammatory drugs along with immunomodulators and anti-fibrotic medications. IFN control the excess production of collagen and stimulates the response of Th1 leading to normal production of fibroblast. The patient should be counseled about the medical treatment options and their various side effects to reap maximum benefits and prevent any complications in the long run. The lifestyle of the patient should be modified accordingly to prevent any adverse effects.
This includes a healthy diet, optimum physical exercise and activity, reducing stress and protecting the skin from sun damage as well as extremes of cold temperature. They will allow in optimum healing of skin and improve the condition faster. Smoking should also be avoided as it can lead to vascular injuries that will only cause worsening of the symptoms.
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