What should you know about dermatology morphea?

Morphea, also called localised scleroderma, affects defined areas rather than causing the widespread internal-organ pattern associated with systemic scleroderma. A patch may begin as pink, purple, or darker skin and gradually become lighter, firmer, or bound down. It may itch, feel tight, or become sensitive. Deeper disease can involve tissue beneath the skin and may restrict movement when it crosses a joint. Morphea can be active for a period and then leave a change in colour or texture after inflammation settles.

A clinician may assess the border, firmness, depth, location, and activity of the patch. A skin biopsy or other assessment may be considered when the diagnosis is uncertain. Treatment choice depends on the extent and depth of disease.

Keep scheduled dermatology reviews so changes in colour, thickness, spread, and movement can be compared. Use a bland moisturiser for dryness and protect exposed areas from sun, which can make colour differences more noticeable. Gentle range-of-motion exercises may help when a patch is near a joint, but painful or restricted movement deserves professional guidance. Limited superficial disease may be treated with prescribed creams, including topical calcineurin inhibitors, while broader or deeper disease may need a different plan. Narrowband UVB phototherapy can be considered for selected superficial areas.

Arrange prompt review if a patch is enlarging, becoming harder, developing a violet border, or causing increasing tightness or pain. Seek earlier assessment when morphea affects an eyelid, face, scalp, hand, or area over a joint, or when movement, vision, swallowing, or function changes. A rapidly changing lesion or an ulcer should also be examined.

Ask whether the morphea appears active, how deep it is, whether a biopsy is useful, and what signs would show that treatment is working. Discuss whether a prescribed topical calcineurin inhibitor or narrowband UVB phototherapy fits the affected area, and ask how to protect movement near a joint.