Author: Dr Shadi Habib, Dermatologist, Ibn al-Walid Hospital, Homs, Syria (2023). Reviewing dermatologist: Dr Ian Coulson
Edited by the DermNet content department
A 52-year-old female patient presented to our clinic complaining of red-brown asymptomatic multiple plaques with defined borders on the abdomen for one year with a peripheral expansion.
On examination, there were oval plaques on the abdomen with a sclerotic centre surrounded by a violaceous border, with some coalescing to form a larger plaque.
There was no mention of any systemic symptoms and laboratory tests were unremarkable.
A skin biopsy was obtained including subcutaneous fat, which demonstrated collagen bundles extending into the reticular dermis, enclosing the eccrine glands and blood vessels.
With the clinical and histological findings, the likely diagnosis is plaque morphoea (morphea).
There are many subtypes of morphoea such as plaque, linear, generalised, and pansclerotic. It is important to evaluate the patient for systemic symptoms and with laboratory tests such as ANA, anti-histone antibodies, and anti-SS DNA antibodies.
In patients with superficial circumscribed lesions, topical treatments are appropriate such as:
For patients with more widespread lesions and deep morphoea, consider:
Rapidly progressive lesions require treatment with systemic corticosteroids or methotrexate.
Morphoea can be chronically active or relapsing and remitting. Deep tissue involvement (eg, subcutaneous tissue, muscle, or bone) can lead to deformity and dysfunction.
