| Localized Scleroderma: Morphea | | | |
| Rare Types of Morphea |
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| Bullous Morphea |
| Collagen XVIII and fibronectin involvement in bullous scleroderma. The dermal distribution and amounts of collagens and in the scleroderma patient are similar to normal skin. Conversely, both fibronectin and collagen XVIII are increased in scleroderma skin, suggesting their involvement in the pathogenesis of bullous scleroderma. PubMed. Dermatol Online J. 2005 Mar 1;11(1):17. |
| Ulcers caused by bullous morphea treated with tissue-engineered skin. A patient with bullous morphea with long-standing ulcers was successfully treated with the tissue-engineered skin Apligraf. The patient experienced rapid improvement in granulation tissue and the ulcers healed 4 months after a single application. Int J Dermatol. 2003 May;42(5):402-4. |
| Case Report: Lichen sclerosus et atrophicus, bullous morphea, and systemic lupus erythematosus. Lichen sclerosus et atrophicus (LSA) rarely coexists with morphea, especially when bullae occur in lesions of morphea. Here we report the case of a 15-year-old girl with this condition, who also fulfilled four out of 11 diagnostic criteria for systemic lupus erythematosus (SLE). J Microbiol Immunol Infect 2000;33:53-6. (Also see: Lichen Sclerosus and Lupus) |
| Case Report: Bullous morphea is a rare disease, which occurs most commonly on the lower extremities and inferior abdomen. Fewer than 100 cases have been reported in the world literature. Multiple authors have concluded that morphea and bullous morphea are distinct manifestations of the same disease. Dermatology Online Journal, vol. 8, no. 2, 2002. |
| Deep Morphea |
| Deep Morphea. In contrast to plaque morphea, which primarily affects the dermis, deep morphea may involve the deep dermis, subcutaneous tissue, fascia, or superficial muscle. In contrast to linear morphea, the lesions of deep morphea are more diffuse (Fig. 4) and do not demonstrate the linear pattern. Mayo Clinic. |
| Deep morphea is characterized by ill-defined, bound-down, sclerotic plaques with a "cobblestone" or “pseudo-cellulite” appearance. The “groove sign” (a depression along the course of a vein, between muscle groups, or both) may be evident later in the course of disease. Deep morphea lesions are frequently hyperpigmented, but, because of the deeper level of inflammation, they lack the other color changes typical of plaque-type morphea. Distribution of lesions is often symmetric. eMedicine. |
| Dermatitis Artefacta or Factitial Dermatitis |
| Dermatitis artefacta. This refers to self-induced or self-aggravated, bizarre lesions without an obvious cause. ISN. |
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| Generalized Morphea |
| Generalized morphea is a form of localized scleroderma. When morphea skin plaques are very widespread, it is referred to as generalized morphea. The skin patches become very hard and dark and spread over large areas of the body. Underlying muscles are often affected, causing them to tighten and atrophy. ISN. |
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| Guttate Morphea |
| Guttate Morphea. An uncommon form of morphea is the guttate variety. It is characterized by multiple, small, chalk-white spots which vary in size from 1 to 10mm in diameter. The violet-colored line may surround all or some of the spots and in cases of long duration the line may be brown or grayish. Guttate morphea primarily involves the chest, neck and shoulders, and only occasionally other parts of the body. Localized morphea may last from a few months to many years. However, a large proportion of morphea patients improve spontaneously. GEX Health Library. |
| Keloid Morphea |
| Keloid or Nodular Scleroderma. Sometimes keloids occur in patients who have scleroderma, and in particular they are more likely to occur in patients with systemic scleroderma. The terms "keloidal" or "nodular" scleroderma are used interchangeably. ISN. |
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Similar to Morphea:
Morpheaform or Sclerosing Basal Cell Carcinoma |
| Morpheaform (sclerosing) (Figure 4). An indurated yellow-to-white plaque with an indistinct border and an atrophic surface characterizes morpheaform or sclerosing basal cell carcinoma (BCC). Ulceration and crusting are usually absent. This variety has an aggressive growth pattern and invasion of muscle, nerve, and bone may be seen. Morpheaform BCC is particularly insidious because of its benign scar-like appearance. Differential diagnosis of morpheaform BCC includes scar and localized superficial scleroderma (morphea). The Cleveland Clinic. |
| Morphea Profunda, also known as Subcutaneous Morphea |
| Subcutaneous morphea (also known as morphea profunda) is noted by deep, bound-down, sclerotic plaques. This occurs much deeper in the skin and because of this the typical inflammatory changes and coloration is not generally seen. American Osteopathic College of Dermatology. |
| Case study: periodic follow-up is necessary in morphea profunda to identify systemic evolution. Although survival rates are no different from that of the general population, localized scleroderma may be associated with development of substantial disability, as occurs in deep morphea and in pediatric patients (disabling pansclerotic morphea of children). PubMed. Skinmed. 2005 May-Jun;4(3):188-90. |
| Subcutaneous Morphea. The primary site of involvement of subcutaneous morphea is in the panniculus or subcutaneous tissue. The lesions are deeper and bound down in comparison with the plaques of the morphea en plaque variant. The onset of sclerosis was relatively rapid, often occurring during a period of several months. The plaques were hyperpigmented, symmetric, and somewhat ill defined. The inflammation was more pronounced than that associated with other types of morphea. Mayo Clinic. |
| Personal Stories of Morphea Profunda |
| Tami: Morphea Scleroderma I have gotten used to the stares everyone casts my way because in their eyes I am different. Unique, I guess... |
| Terri: Subcutaneous Morphea I was finally diagnosed with deep morphea (or subcutaneous morphea) around mid February 2007, after having a biopsy... |
| Terry E. (Mojoy the Clown): Morphea Profunda Linear Scleroderma My right lower leg started to swell and the ankle grew big. It hurt all the time... |
| Pansclerotic Morphea |
| Pansclerotic Morphea is an exceedingly rare and severe form of morphea, which can be very disabling and sometimes even fatal. There are only a few reported cases of pansclerotic morphea in medical literature. ISN. |
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