Morphea is a rare skin condition wherein certain areas of skin get thickened and dry forming lesions. Hardening of skin occurs in the abdomen and back regions and sometimes on the chest. For some people skin thickening is destined to specific organs or parts of the body but for others it is generalized. In addition to the skin changes, the underlying tissues and even the bones also gets hardened in morphea. In severe forms this condition can reduce the joint movements causing trouble in walking and eating. Exact cause of morphea is not known and treatments are available in the form of therapies and drugs.
Morphea Causes :
It is not known how skin changes occur in affected individuals. It is believed to occur due to environmental as well as genetic factors. Scientifically, collagen production in the skin becomes over-activated and sensitive releasing large amounts which in turn get deposited in the dermis layer. But it is not clear what triggers such reaction. This event would gradually damage and destroy the underlying blood vessel which releases cytokines which leads to scarring of skin and hardening of skin.
Some experts believe morphea occurs due to the response of immune disorder. The body’s immune system gets triggered resulting in over-production of cytokines causing thickened skin. For some people morphea occurs after undergoing radiation treatment and if they have recently been infected by chickenpox or measles virus. Certain autoimmune disorders like diabetes, thyroid problems and lichen planus can also cause morphea.
Classification Of Morphea and Symptoms :
Morphea can be grouped according to the part or region that is affected.
- Plaque Morphea – This kind of morphea would cause hardened skin on the trunk (abdomen) and limbs area. Oval shaped patches measuring 5-20 cm in diameter are found in the skin. The color of such patches may vary from ivory white to light brown. For some people plaqaue like lesions are found on the hips and even on the breasts. In severe cases, it can affect the underlying tissues and bones.
- Generalized Morphea – This category of morphea is not quite common. Here plaque like lesions affects more than two regions of the body.
- Superficial Morphea – This type is found in aged women affecting the armpits, groin and breasts region wherein there is folded skin.
- Pansclerotic Morphea – This type rarely occurs in children causing hardening of skin and muscle and sometimes even the underlying bones. Bone growth is not normal in such children causing contractures and ulcers.
- Atrophoderma – In this type subcutaneous tissue of the skin is totally lost causing depression under the skin. This category is very rare.
Symptoms range from mild to severe according to the part of the body affected and intensity of disease. Some of the common signs of morphea include joint pain, inflammation of joints, headache, fatigue, and epilepsy and vision problems. It can cause moderate neurological defects in affected children.
Some of the characteristic features of morphea include red or pink colored patches and discoloration of the skin affecting the neck, chest and abdomen area. The color of such patches varies from white to brown. Skin changes do not happen overnight but it happens gradually. It can cause loss of hair in the affected area and sweating may not occur in those areas. In severe form, morphea affects the underlying tissue along with bone. The joints become stiff affecting limb movement and calcium deposits increases in the bones causing complications.
Risk Factors :
Being Caucasian and female particularly increases the risk of developing morphea, though this disorder can occur to anyone. Children in the age group of 2-14 and adults above 40 years are prone to morphea or skin thickening problem.
Dermatologist can detect morphea by mere physical examination. Skin biopsy can be done for confirming the diagnosis. Laboratory tests would reveal thickening of skin due to increased amounts of collagen. Children with morphea on the neck and head should go for regular eye-checkups since morphea can significantly affect their vision. Your doctor may order for imaging tests like X-rays, ultrasound scan and MRI or CT scan for identifying the extent of progression of morphea.
Morphea Treatment :
Morphea often does not require any treatment, since it goes on its own after some weeks. It may cause discoloration of skin on the affected regions.
- Controlled light rays of ultraviolet radiation are sent to the affected skin layers in repeated sessions until the hardening of skin disappears.
- Oral pills are prescribed for people whose immunity has been compromised. Drug slike methotrexate is given alone or sometimes combined with steroid pills.
- Vitamin D cream by name calcipotriol or tacrolimus is prescribed to soften the skin in the affected parts. Skin discoloration gradually reduces over time on applying this cream.
- Physiotherapy is given for people for whom joint inflammation has restricted the movement of legs and hands.
- Moisturizing lotion can be applied generously on the affected skin to improve the symptoms. Hot showers should be avoided since it may worsen the symptom.
Since severe form of morphea can change your looks, self esteem can be affected. It is wise to seek help from registered counseling service or join a support team.