What should you know about morphea back?

Morphea, also called localised scleroderma, affects the skin and sometimes the tissue beneath it. A patch may begin with a change in colour, then feel firmer or tighter as it evolves. On the back, a person may notice an uneven patch, reduced flexibility, itch, or a difference in texture rather than pain. A photograph and examination over time can help distinguish active inflammation from a patch that has become inactive.

Book a dermatology review for a new firm or changing patch. The clinician may examine its borders, texture, pigmentation, and movement, and may consider a biopsy when the diagnosis is uncertain. Treatment depends on activity, location, and depth. Topical calcineurin inhibitors may be considered for selected superficial disease, while narrowband UVB phototherapy can be discussed when a broader superficial area needs treatment. Moisturiser can reduce tightness, but it does not replace assessment.

Seek review promptly if a patch is enlarging, becoming harder, changing colour, restricting movement, or involving a joint. Ask for earlier assessment if there is pain, ulceration, marked sensitivity, or a new patch on the face or near the spine. Rapid change does not prove a serious cause, but it helps the clinician identify active disease.

Does this patch look active or inactive? How deep does it appear? Would a biopsy, topical treatment, or phototherapy be appropriate? How should I track its borders and flexibility?