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Morphea or Localized Scleroderma Morphea refers to a group of disorders with skin and subdermal connective tissue adjustments due to extreme accumulation of collagen Circumscribed morphea o Includes type of superficial lesions previously generally known as пїЅplaqueпїЅ morphea o May includes superficial and deep dermis in addition to subcutaneous tissues o Typically firm, ivory-coloured oval lesions surrounded by reddish-lilac coloured ring suggesting energetic inflammation o Later, there is atrophy, hyperpigmentation and softening over time Generalized morphea o When individual circumscribed lesions turn out to be confluent or affect fi3 anatomic websites Linear scleroderma o Most common kind in youngsters and adolescents o Characterized by fi 1 linear streaks (typically following dermatomal distribution) extending over an higher or lower extremity o Unilateral in > eighty five% circumstances o May prolong over joints, limiting range of movement o En coup de sabre > linear lesion involving face or scalp, normally brow o Parry-Romberg syndrome > progressive hemi-facial atrophy, extra disfiguring o Both forms of facial linear scleroderma could also be related to intracranial lesions, seizures, uveitis, and dental abnormalities Pansclerotic morphea o Least widespread subtype, but most disabling o Circumferential changes (typically affecting a limb) that stretch into tissues below dermis including muscle, tendon and bone o Frequently spares the fingers and toes Mixed morphea o Morphea of fi 2 subtypes in an individual patient Treatment options: o Topical: emollients, corticosteroids, Calcipotriene (vitamin D) o Systemic: corticosteroids, Methotrexate, Mycophenolate mofetil, Cyclosporine o Other: Psoralen with Ultraviolet A radiation therapy References: 1 harrison internal medicine [url=http://www.noankhistoricalsociety.org/rxmed/order-isoniazid-online-no-rx/]generic isoniazid 300 mg with amex[/url]. 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