Generalised morphea: what to know

Morphea is an inflammatory condition that can make skin feel firm, tight, shiny, or bound down. Early patches may look pink, purple, or darker than surrounding skin before becoming pale or hardened. Generalised disease involves multiple plaques or larger connected areas. The depth varies: some changes remain in the skin, while deeper involvement can affect tissue beneath it and restrict movement near a joint.

Morphea is different from systemic scleroderma, but a clinician still needs to assess the distribution, activity, depth, and effect on movement. Photographs and examination over time can help show whether active inflammation is continuing.

Arrange specialist review rather than treating firm patches as simple dryness. Keep affected skin moisturised, protect it from friction, and gently maintain movement unless a clinician advises otherwise. Treatment depends on activity, depth, body area, and extent. Options may include narrowband UVB phototherapy for suitable superficial disease or topical calcineurin inhibitors for selected areas. Deeper or active disease may need a different plan, so do not borrow steroid or immune-modifying medicine.

Seek review if new patches appear, existing areas expand or become more purple and inflamed, or tightness begins to limit a joint, walking, eating, or another daily activity. Prompt assessment is appropriate for pain, ulceration, marked swelling, or rapid change. A child with a patch crossing a growing joint needs timely specialist attention because movement can be affected.

Ask how deep and active the morphea appears, whether photographs or imaging would help, and what movement exercises are safe. Discuss whether narrowband UVB phototherapy or a topical calcineurin inhibitor fits the affected areas and how response will be reviewed.