Morphea (Question
and Answer)
by Philip Clements, M.D., UCLA School of Medicine,
Department of Rheumatology, (originally published in
"Scleroderma Voice," Spring 2001)
Question: My 5-year-old daughter was
diagnosed with morphea when she was 3. Due to the serious
side effects, I've decided not to let her take any medication.
Is there a possibility her disease will go away some
day?
Also, the four fingers on her left hand are totally
bent and tiny.
 |
| Philip
Clements , M.D., M.P.H. |
She has a waxy patch on the left side of her chest.
Is there any test that can tell whether her deeper layers
of skin are OK, and whether her chest will grow like
normal women? Is it possible the morphea could turn
into linear scleroderma?
Otherwise she seems healthy, eats well, and is smart.
Ms. L.W., San Gabriel, Calif.
Answer: Morphea is a type of scleroderma
(hard skin) which affects the upper layer of skin but
not the deeper layers of fat or muscle under the skin
nor the internal or visceral organs. It typically appears
as a thin, oval-shaped patch of thickening in the skin,
often with a purple, brown, or white appearance and
a red rim.
Linear scleroderma, another form of localized scleroderma,
tends to affect not only the upper layer of skin but
also the underlying fat and muscles. It presents as
a "swath" of involvement down an extremity,
one half of the face or one half of the torso.
Early on there may be darkening and swelling of the
skin, but over time the involved tissue (skin, fat,
muscle) may thin or atrophy.
If this involvement occurs over a joint or on the
hand in a youngster, it may limit joint motion (produce
a contracture or a deformity) and may retard growth
of underlying bone.
Linear scleroderma tends to run a course which includes
scarring and fibrosis, followed by atrophy. There is
no clear consensus about whether there is any medication
or treatment which can alter this course.
My supposition is that the young girl described has
linear scleroderma affecting the left hand, arm, and
chest, and she may also have a patch of morphea.
If you have not done so already, I suggest that you
find a doctor who has experience in the scleroderma-spectrum
diseases, so that an accurate determination can be made
of the problem and its potential outcome and treatment.
The Scleroderma Foundation can supply names of scleroderma-knowledgeable
physicians in your area. |
