What should you know about morphea en plaque?

A plaque is a broad, relatively flat area of altered skin. In morphea en plaque, the centre may look lighter, darker, or ivory while the edge can appear pink, lilac, or more inflamed when the process is active. The surface may feel smooth, firm, tight, or mildly itchy. Common sites include the trunk and limbs, although examination is needed to confirm the pattern and exclude other causes of a scar-like patch.

A dermatologist may compare the patch with photographs, check its borders and flexibility, and consider a biopsy if the diagnosis is unclear. Treatment is selected according to activity, size, site, and depth. Topical calcineurin inhibitors may suit selected superficial patches. Narrowband UVB phototherapy is another option that may be discussed for suitable superficial or more widespread areas. Use bland moisturiser for dryness and avoid friction over tender skin.

Seek assessment when a patch is new, enlarging, becoming firmer, or changing at its border. Earlier review is sensible if tightness limits movement, the area is painful, or the face, hands, or a joint is involved. Contact a clinician for ulceration or sudden marked change rather than waiting for routine monitoring.

Is this plaque active? How deep is it? Should I photograph it at home? Would a topical medicine or phototherapy fit its location and stage?