Morphea

By Alan W. Friedman, M.D., University of Texas/Houston, Health Science Center, Dept. of Internal Medicine/Rheumatology (originally published in "Scleroderma Voice," 2001 #3)

Question: What is severe generalized morphea? What action can be taken to prevent generalized morphea from progressing? I have heard something about light treatment. I have also heard that morphea does not turn into systemic sclerosis. Is this true?

Answer: Morphea is a form of "localized" scleroderma, rather than "systemic" scleroderma.

The other major localized form is called "linear scleroderma," which looks almost like someone took a knife and cut a line across the skin.

"Localized" means it is confined to the skin and does not cause collagen deposition in internal organs (intestinal tract, lungs, kidneys, etc.). It can range from a few small spots on the skin to a more generalized problem, but it does not turn into systemic scleroderma (assuming the diagnosis is correct).

I know that some scleroderma experts use methotrexate for the most severe forms (including severe linear scleroderma), and while I have not seen patients treated with light, I can see how it might work. This is something you should discuss with your treating physician. I would try to find a dermatologist who has expertise in scleroderma for an opinion.