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Causes of Morphea Scleroderma

Autoimmunity
Cancer, Lymphoma
Genetics
Infections
Borrelia Burgorferi
HTLV-1 Infection
Toxoplasma Gondii
Medications
Valproic Acid
Radiation
Solvents, Organic Solvents
Vaccinations

Overview

The cause of morphea scleroderma is unknown in most cases, however sometimes it has been association with cancer, infections, medications, radiation, solvents, and vitamin B12. Gene profiling is underway to determine the genes associated with the development of morphea.

Morphea is a form of localized scleroderma, which usually affects only the skin or underlying muscles and joints.

Generally speaking, localized scleroderma is substantially different from systemic scleroderma, since systemic scleroderma often affects the skin, blood vessels, and/or internal organs. (Also see Morphea Scleroderma, Types of Scleroderma and Causes of Systemic Scleroderma)

Autoimmunity

(Case Report) A rare association of localized scleroderma (LS) type morphea, vitiligo, autoimmune hypothyroidism, pneumonitis, autoimmune thrombocytopenic purpura and central nervous system vasculitis. It is likely that localized scleroderma has an autoimmune origin and in this case becomes part of multiple autoimmune syndrome (MAS), which consist of the presence of three or more well-defined autoimmune diseases in a single patient. PubMed, BMC Res Notes. (Also see Vitiligo, Hashimoto's Thyroiditis, Idiopathic Thrombocytopenic Purpura, Vasculitis, and Multiple Autoimmune Syndrome)

Cancer, Lymphoma, HTLV-1 Infection

Morphea has been associated with T-cell lymphoma in several case reports. A very rare form of T-cell lymphoma is due to a virus (an HTLV-1 infection) and this virus has been associated in at least one case with guttate morphea. When this type of lymphoma is identified by high calcium in blood, bone and skin lesions, and lymphoma cells in blood and bone marrow, your doctor will order special blood tests to check for the virus.

Scleroderma and Cancer. Systemic scleroderma may be associated with an increased incidence of cancer, including breast cancer, B-cell lymphoma, lung cancer and tongue cancer. ISN.

Genetics

This DNA Registry continues until 2020.

Morphea in Adults and Children (MAC) Cohort Study: A Morphea Registry and DNA Repository. The Morphea in Adults and Children (MAC) cohort is the first registry for both children and adults with morphea (Also known as localized scleroderma) in the country. Study continues until 2020. ClinicalTrials.gov.

Infections

Borrelia burgdorferi

Lyme borreliosis and skin. Many other dermatological conditions including morphea, lichen sclerosus and lately B cell lymphoma, have been attributed to the disease. Indian J Dermatol 2013;58:167-74.

HTLV-1 Infection, Lymphoma, and Morphea

Causes of Morphea: Cancer. Morphea has been associated with T-cell lymphoma in several case reports. See above, Causes of Morphea: Cancer.

Toxoplasma gondii

Circumscribed scleroderma or morphea is a rare disease that involves limited areas of skin and usually is not associated with visceral lesions. We present a case of a male patient, which developed morphea lesions during the infection with Toxoplasma gondii. The evolution of lesions was correlated with antibodies titre for Toxoplasma gondii, and local administration of corticosteroids accelerated the evolution to cutaneous lesions stabilization. PubMed, Rev Med Chir Soc Med Nat Iasi. 107(3):646-9.

Medications

Valproic Acid

Localized morphea: a rare adverse effect of valproic acid. To our knowledge, this is the first patient reported to have an apparently valproic acid-induced localized morphea. PubMed, Pediatr Neurol. 2003 Sep;29(3):253-5.

Radiation

Postirradiation morphea in a breast cancer patient. It is important to be aware of this rare complication of radiation therapy because it clinically presents with symptoms mimicking malignancy and may be misinterpreted as recurrent carcinoma or even angiosarcoma. PubMed, Breast J. 2006 Mar-Apr;12(2):173-6. (Also see Cancer and Scleroderma)

Postirradiation morphea and subcutaneous polyarteritis nodosa: Case report and literature review. Postirradiation morphea is an uncommon condition but is being increasingly recognized. Related phenomena following radiation include postirradiation panniculitis and now postirradiation subcutaneous polyarteritis nodosa. Radiation may be responsible for inducing some of the pathogenic changes seen in scleroderma and other autoimmune diseases. PubMed, Semin Arthritis Rheum. 2005 Apr;34(5):728-34. (Also see Associated Conditions: PAN, and Causes of Scleroderma: Radiation)

Solvents, Organic Solvents

Amyloid deposition associated with generalized morphea-like scleroderma. (The patient) had been occupationally exposed to organic solvents. As far as we know, amyloid deposition associated with generalized morphea-like scleroderma has not been reported until now. PubMed, Eur J Dermatol. 2003 Sep-Oct;13(5):509-11. (Also see Causes of Scleroderma: Environmental)

Vaccinations and Morphea Scleroderma

Primary Atrophic Solitary Morphea Profunda. Here, we describe a patient presenting with noninflammatory cupuliform (shaped like a small cup) depressed plaques, without any significant skin induration, pigmentation or texture change, that appeared on the left shoulder at a site of previous intramuscular vaccination. Our observation highlights the wide spectrum of clinical presentations of localized scleroderma. The latter should be considered in the presence of lipoatrophy-like lesions for proper workup and therapy. (Also see Lipodystrophy and Morphea Profunda)

Deep Morphea after Vaccination in Two Young Children. Pediatric Dermatology Volume 23 Issue 5, Pages 484 - 487, 27 Sep 2006. (Also see Morphea Scleroderma and Causes of Scleroderma: Vaccinations)

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