Materiały źródłowe

• #1 Morphea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/morphea/symptoms-causes/syc-20375283

  Morphea is a rare skin condition characterized by small red or purple patches that develop firm white or ivory centers. The affected skin becomes tight and less flexible. […] Morphea usually improves on its own over time, though recurrences are common. In the meantime, medications and therapies are available to help treat the skin discoloration and other effects. […] Morphea affects the skin and underlying tissue and sometimes bone. The condition generally lasts several years and then improves or at times disappears by itself. It may leave scars or areas of darkened or discolored skin. It is possible for morphea to recur. […] See your doctor if you notice reddish patches of hardening or thickening skin. Early diagnosis and treatment may help slow the development of new patches and allow your doctor to identify and treat complications before they worsen.

• #2 Morphea – Therapeutics in Dermatology

  https://www.therapeutique-dermatologique.org/spip.php?article1641

  Morphea is a rare, autoimmune skin disease characterized by inflammation and sclerosis (hardening) of the skin and soft tissues and may lead to scar-like lesions. […] The treatment for morphea depends on the type (linear, plaque or generalized), the age of the patients and whether it has spread underneath the skin. […] Early treatment is especially important for linear and generalized morphea to prevent further consequences, like loss of mobility. […] Morphea dries the affected skin, so moisturizers may help soften and improve symptoms like itch. […] Patients may start by seeing their primary care doctor. They may refer them to a doctor who specializes in skin disorders (dermatologist) or a specialist in diseases of the joints, bones and muscles (rheumatologist). […] Psychological support may be provided by primary care doctor or a mental health professional.

• #3 Morphea (localized scleroderma) in adults: Management – UpToDate

  https://www.uptodate.com/contents/morphea-localized-scleroderma-in-adults-management

  Morphea, also known as localized scleroderma, is an idiopathic inflammatory disorder that causes sclerotic changes in the skin. Affected patients present with single or multiple inflammatory and sclerotic plaques, findings considered manifestations of active disease. These plaques eventually become inactive, leaving permanent dermal or soft tissue atrophy and pigmentary changes (skin damage). […] There are multiple treatment options for active morphea; however, evidence in support of many of these therapies is limited. The majority of patients are managed with observation, topical medications, phototherapy, or systemic immunosuppressive therapy. The level of disease activity; depth of involvement; body surface area involved; and the presence of functional impairment, extracutaneous manifestations, or cosmetic disfigurement determine the most appropriate approach to treatment (algorithm 1).

• #4 Morphea (Localized Scleroderma) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/morphea-localized-scleroderma/

  Morphea may present at any age. In children, the linear subtype predominates while in adults plaque and generalized subtypes are most common. Morphea occurs more frequently in women, especially in adults where female predominance is marked (5:1). […] Morphea is not the same as scleroderma (systemic sclerosis), and it does not become scleroderma. Key differences include presence of the following in scleroderma, NOT morphea: acrosclerosis/sclerodactyly; Raynauds phenomenon; antibodies such as anti-centromere, Scl-70, and RNA polymerase; and characteristic internal organ involvement. […] Clinical evolution of morphea lesions may occur very rapidly or over months; patients often have a mixture of active and inactive lesions: Active inflammatory lesion; plaque with erythematous or violaceous border; may have central white yellow sclerosis and/or indurated border

• #5 Morphea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559010/

  Morphea, also called localized scleroderma, is a rare inflammatory skin condition that can also affect the subcutaneous tissues. […] This activity reviews the evaluation and treatment of morphea and highlights the role of the interprofessional team in caring for patients with this condition. […] Outline the importance of improving care coordination amongst the interprofessional team to enhance the care of patients with morphea. […] Clinicians should review the subtype of morphea, the depth of involvement, and disease activity, which play a significant role in treatment decisions. Early diagnosis and treatment are necessary to minimize damage such as cosmetic sequelae and joint contractures or limb deformities in patients with severe forms of morphea. […] A coordinated effort of health care providers that includes primary clinicians, dermatologists, and rheumatologists is necessary for early diagnosis and treatment. It is essential to do appropriate testing to differentiate morphea from systemic sclerosis, which has a poor prognosis due to systemic organ involvement. […] Patient education helps them to make informed decisions about the treatment options and prognosis of morphea.

• #6 Frequently Asked Questions about Morphea: Department of Dermatology – UT Southwestern, Dallas, Texas

  https://www.utsouthwestern.edu/education/medical-school/departments/dermatology/research/morphea-registry/disease-faq.html

  The cause of morphea is unknown, but it is thought that the collagen-producing cells become overactive and overproduce collagen. This can result in areas of sclerosis or skin hardening. Researchers are trying to determine what triggers the disease and whether it is genetic in origin. […] Morphea is more common in women than in men and about half of all patients first show signs before the age of 18. There is very little information about who are at highest risk for getting morphea as there are no known predictors for the disease. Data from our registry indicates that other autoimmune diseases are more common in patients with morphea and possibly their relatives as well. […] Your doctor will help determine what treatment is best for your particular situation. Some examples of therapies used for morphea are:

• #7 Morphea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/morphea/symptoms-causes/syc-20375283

  Morphea is a rare skin condition characterized by small red or purple patches that develop firm white or ivory centers. The affected skin becomes tight and less flexible. […] Morphea usually improves on its own over time, though recurrences are common. In the meantime, medications and therapies are available to help treat the skin discoloration and other effects. […] Morphea affects the skin and underlying tissue and sometimes bone. The condition generally lasts several years and then improves or at times disappears by itself. It may leave scars or areas of darkened or discolored skin. It is possible for morphea to recur. […] See your doctor if you notice reddish patches of hardening or thickening skin. Early diagnosis and treatment may help slow the development of new patches and allow your doctor to identify and treat complications before they worsen.

• #8 Morphea (Localized Scleroderma) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/morphea-localized-scleroderma/

  Morphea may present at any age. In children, the linear subtype predominates while in adults plaque and generalized subtypes are most common. Morphea occurs more frequently in women, especially in adults where female predominance is marked (5:1). […] Morphea is not the same as scleroderma (systemic sclerosis), and it does not become scleroderma. Key differences include presence of the following in scleroderma, NOT morphea: acrosclerosis/sclerodactyly; Raynauds phenomenon; antibodies such as anti-centromere, Scl-70, and RNA polymerase; and characteristic internal organ involvement. […] Clinical evolution of morphea lesions may occur very rapidly or over months; patients often have a mixture of active and inactive lesions: Active inflammatory lesion; plaque with erythematous or violaceous border; may have central white yellow sclerosis and/or indurated border

• #9 Morphea | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816329/0.4/Morphea

  A benign inflammatory skin disorder leading to excessive collagen deposition with thickening and sclerosis of the skin and subcutaneous tissues with characteristic plaque formation. […] Lesions are well circumscribed, flat, firm to touch, and have a waxy feel. […] They are ivory colored and have a lilac or erythematous halo border. […] Lesions are not associated with systemic sclerosis (scleroderma) based on lack of sclerosis of fingertips (sclerodactyly), Raynaud phenomenon, and nail fold capillary changes. […] Morphea is classified into five types (Mayo classification): Plaque: most common subtype especially in adults, well circumscribed, and confined to dermis. […] Generalized: 4+ plaques involving 2+ body sites. […] Linear: most common subtype in children. […] Deep: more severe and involving all layers from skin to bone, causing limb contractures and muscle atrophy.

• #10 Morphea | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25270

  Morphea, also referred to as localized scleroderma, is a rare inflammatory disease of the skin and subcutaneous tissue. Morphea symptoms are usually limited to the skin and the subcutaneous tissue. Still, extracutaneous involvement is reported in approximately 22% of patients, with linear and generalized subtypes in a cohort reported by Zulian et al. Localized scleroderma can rarely cause debilitating lesions, which result in joint contractures, limb growth defects, and other extracutaneous features in children. […] Clinicians should review the subtype of morphea, the depth of involvement, and disease activity, which play a significant role in treatment decisions. Early diagnosis and treatment are necessary to minimize damage such as cosmetic sequelae and joint contractures or limb deformities in patients with severe forms of morphea.

• #11 Pathology Outlines – Morphea and systemic sclerosis

  https://www.pathologyoutlines.com/topic/skinnontumorscleroderma.html

  Morphea and systemic sclerosis are rare autoimmune fibrosing entities subtyped based on clinical presentation. […] Dysregulation of collagen synthesis and degradation causes vascular and immune dysfunction, leading to organ damaging fibrosis. […] Localized scleroderma (morphea) is divided into limited/circumscribed, generalized, linear, deep, and mixed types. […] Systemic sclerosis includes limited cutaneous systemic sclerosis, diffuse cutaneous systemic sclerosis, and systemic sclerosis sine scleroderma. […] The clinical features of localized scleroderma include skin thickening and potential involvement of underlying tissues. […] Systemic sclerosis can lead to significant complications affecting the skin, lungs, heart, and kidneys. […] Multidisciplinary care is required due to the involvement of several organs in systemic sclerosis. […] Treatment for localized scleroderma may include topical therapy, systemic therapy, phototherapy, physical therapy, and surgical interventions. […] For systemic sclerosis, an organ-based approach is necessary to determine organ involvement and disease activity.

• #12 Morphea Information for Patients | RDS

  https://www.rheumaderm-society.org/morphea-information-for-patients/

  Morphea (syn. localized scleroderma) occurs as a result of autoimmune fibrosing (leather-like) injury to the skin and sometimes the underlying fat, muscle and bone. […] In morphea, the immune system mistakenly causes inflammation of the skin. This inflammation then causes fibrosis (hardening) of the skin and underlying tissues. […] Adult-onset morphea (circumscribed morphea, generalized morphea). Circumscribed morphea causes circular fibrosis of the skin and subcutaneous fat in one to three areas. […] Generalized morphea presents as four or more areas of skin and subcutaneous fibrosis. […] Patients with generalized morphea may experience fatigue and joint pain. […] Patients with generalized and pansclerotic morphea may experience difficulty with deep breathing, if all of the skin on their chest is involved.

• #13 Scleroderma (syn. morphoea)

  https://www.pcds.org.uk/clinical-guidance/scleroderma-syn-morphoea

  Morphoea (syn. scleroderma) is a group of related conditions that share a common pathophysiology of increased collagen deposition in an autoimmune setting. Morphoea presents with varying degrees of sclerosis, fibrosis and atrophy in the skin and subcutaneous tissues sometimes extending into the fascia, muscle, bone, eye, and brain. […] Morphoea is best considered as a separate entity to systemic sclerosis, which unlike morphoea results in Raynaud’s phenomenon, sclerodactyly (spindled fingers), nailfold capillary changes, and systemic involvement. […] Although morphoea is of unknown aetiology, it is believed that both genetic and environmental factors have a role to play. […] Morphoea has also been associated with: Drugs eg carbidopa, penicillamine; Chemicals eg polyvinyl chloride, solvents used in dry cleaning, and pesticides; Graft-versus-host disease following bone marrow transplantation.

• #14 Pediatric morphea (scleroderma) – Children’s Health

  https://www.childrens.com/specialties-services/conditions/morphea

  Morphea (morphea) is an uncommon persistent condition in which there are areas of thickened skin. It is also known as localized scleroderma (scleroderma). It may affect adults or children. […] Plaque-type morphea is usually active for several years then slowly softens, leaving brown staining and sometimes depressed areas of skin. Linear morphea lasts longer, but also eventually improves, although sometimes deposits of calcium arise within the lesions. Limbs affected by severe morphea may be stiff and weak if there is muscle wasting. […] In nearly all cases the cause of morphea is unknown. It can however sometimes follow: Localized injury, Tick bites – it has been associated with Lyme disease, Pregnancy, Measles and other viral infections, Autoimmune diseases including lichen sclerosus and lichen planus. […] Topical calcipotriol, Intralesional steroid injections, Phototherapy, Cyclosporin, Pentoxifylline, Penicillamine, Diphenylhydantoin (phenytoin), Methotrexate, Antibiotics.

• #15 Morphea Information for Patients | RDS

  https://www.rheumaderm-society.org/morphea-information-for-patients/

  Morphea treatment depends on morphea subtype. Most patients with circumscribed morphea will do very well with medicated creams. […] Patients with generalized, linear, mixed and pansclerotic morphea may need light therapy or pills to suppress the inflammation. […] All patients will have less itching and symptoms if the morphea lesions are kept moisturized. […] Morphea does not tend to run in families; however, if you have morphea your family has a slightly increased risk of having other autoimmune diseases such as vitiligo, psoriasis, lupus, and thyroiditis.

• #16 Frequently Asked Questions about Morphea: Department of Dermatology – UT Southwestern, Dallas, Texas

  https://www.utsouthwestern.edu/education/medical-school/departments/dermatology/research/morphea-registry/disease-faq.html

  The cause of morphea is unknown, but it is thought that the collagen-producing cells become overactive and overproduce collagen. This can result in areas of sclerosis or skin hardening. Researchers are trying to determine what triggers the disease and whether it is genetic in origin. […] Morphea is more common in women than in men and about half of all patients first show signs before the age of 18. There is very little information about who are at highest risk for getting morphea as there are no known predictors for the disease. Data from our registry indicates that other autoimmune diseases are more common in patients with morphea and possibly their relatives as well. […] Your doctor will help determine what treatment is best for your particular situation. Some examples of therapies used for morphea are:

• #17 Morphea (Localized Scleroderma) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/morphea-localized-scleroderma/

  Sclerotic lesion; thickened, hardened plaque with minimal erythema […] Atrophic (inactive) lesion; hypo/hyperpigmented plaque with dermal or subcutaneous atrophy. […] Diagnosis is usually based on clinical findings as described above. There are no widely accepted markers for diagnosis, prognosis, or disease activity. […] Morphea causes functional, psychologic, and neurologic complications. Morphea in children may cause growth retardation and muscular atrophy of affected limbs as well as limitation of range of motion and contracture, especially in deep lesions spanning joints or affecting the majority of the surface area of an extremity. Pain, sometimes severe, is reported in patients with deep involvement or circumferential involvement of an extremity. […] Pruritus, numbness, and tingling are common complaints and may be a marker of disease activity. Low quality-of-life is a problem not only involving teenagers and children but also adults, especially those with large numbers of lesions or functional impairment.

• #18 Morphea (Localized Scleroderma) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/morphea-localized-scleroderma/

  Sclerotic lesion; thickened, hardened plaque with minimal erythema […] Atrophic (inactive) lesion; hypo/hyperpigmented plaque with dermal or subcutaneous atrophy. […] Diagnosis is usually based on clinical findings as described above. There are no widely accepted markers for diagnosis, prognosis, or disease activity. […] Morphea causes functional, psychologic, and neurologic complications. Morphea in children may cause growth retardation and muscular atrophy of affected limbs as well as limitation of range of motion and contracture, especially in deep lesions spanning joints or affecting the majority of the surface area of an extremity. Pain, sometimes severe, is reported in patients with deep involvement or circumferential involvement of an extremity. […] Pruritus, numbness, and tingling are common complaints and may be a marker of disease activity. Low quality-of-life is a problem not only involving teenagers and children but also adults, especially those with large numbers of lesions or functional impairment.

• #19 5 Ways to Relieve Morphea Itch | Morphea Treatment & Relief

  https://resources.healthgrades.com/right-care/skin-hair-and-nails/5-ways-to-relieve-morphea-itch

  Morphea is an autoimmune disease that causes hard, tight patches—also called lesions or plaques—on the skin. Morphea is a form of localized scleroderma that can affect only the top layer of skin, or it can penetrate the fat, muscles, joints or bones. While the condition is usually painless, the patches can become dry and itchy. Some people may choose not to treat the condition because it often goes away on its own within five years. Some morphea symptoms may be bothersome and can be treated. Morphea treatment won’t cure the condition. However, some treatments can reduce symptoms and provide morphea itch relief. […] Keeping the lesions moisturized can help relieve itching. Choose a thick cream rather than a lotion, and apply it twice a day for best results. A moisturizer with camphor and menthol can help cool your skin and relieve itch. In addition, try a warm (not hot) bath with baby oil or oatmeal to soothe your skin.

• #20 Morphea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/morphea/symptoms-causes/syc-20375283

  Morphea can cause a number of complications, including: Self-esteem issues. Morphea can have a negative effect on your self-esteem and body image, particularly if discolored patches of skin appear on your arms, legs or face. […] Movement problems. Morphea that affects the arms or legs can impair joint mobility. […] Widespread areas of hardened, discolored skin. Numerous new patches of hardened, discolored skin may seem to join together, a condition known as generalized morphea. […] Loss of hair and sweat glands. Over time, you may lose hair and sweat glands in the affected area. […] Eye damage. Children with head and neck morphea may experience unnoticeable but permanent eye damage.

• #21 Morphea (Localized Scleroderma) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/morphea-localized-scleroderma/

  Sclerotic lesion; thickened, hardened plaque with minimal erythema […] Atrophic (inactive) lesion; hypo/hyperpigmented plaque with dermal or subcutaneous atrophy. […] Diagnosis is usually based on clinical findings as described above. There are no widely accepted markers for diagnosis, prognosis, or disease activity. […] Morphea causes functional, psychologic, and neurologic complications. Morphea in children may cause growth retardation and muscular atrophy of affected limbs as well as limitation of range of motion and contracture, especially in deep lesions spanning joints or affecting the majority of the surface area of an extremity. Pain, sometimes severe, is reported in patients with deep involvement or circumferential involvement of an extremity. […] Pruritus, numbness, and tingling are common complaints and may be a marker of disease activity. Low quality-of-life is a problem not only involving teenagers and children but also adults, especially those with large numbers of lesions or functional impairment.

• #22 Morphea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/morphea/diagnosis-treatment/drc-20375290

  Your doctor may diagnose morphea by examining the affected skin and asking about your signs and symptoms. […] It’s important to distinguish morphea from systemic scleroderma and other conditions. […] If your child has head and neck morphea, take him or her for regular comprehensive eye exams, as morphea may cause unnoticeable yet irreversible eye damage. […] Morphea usually lasts several years and then goes away without treatment. […] Until your condition clears up, you may want to pursue treatment that helps control your signs and symptoms. […] Treatment options vary depending on the extent of your condition and how it’s affecting your life. […] Your doctor may prescribe a vitamin D cream, such as calcipotriene, to help soften the skin patches. […] Or your doctor may prescribe a corticosteroid cream to reduce inflammation.

• #23 Morphoea (localised scleroderma, morphea)

  https://dermnetnz.org/topics/morphoea

  Morphoea may be asymptomatic, or symptoms may arise from the skin or deeper tissues, or they may due to extracutaneous manifestations. […] Up to 30% of patients with more severe types of linear or generalised morphoea can have extracutaneous non-specific inflammatory symptoms. […] The diagnosis of morphoea is often made clinically, without the need for further tests. […] There is no cure for morphoea. Treatment is aimed at halting ongoing disease activity and progression. […] Specific treatment decisions in morphoea are guided by the subtype of morphoea and its severity. […] Disease progression and treatment response can be monitored using photographs, the localized scleroderma cutaneous assessment tool (LoSCAT) and other highly specialised tests. […] Morphoea can follow a protracted course, which can be relapsing and remitting, or chronically active. Milder forms of the disease tend to become inactive within 3 to 5 years.

• #24 Morphea: a practical review of its diagnosis, classification and treatment

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0016-38132019000500483

  Morphea, or localized scleroderma, is a rare disease of the connective tissue that manifests itself with localized sclerosis of the skin and, in some cases, with extracutaneous manifestations. […] Diagnosis and management of patients with morphea is not always easy and can be a challenge for the dermatologist. In this article, the basic concepts of the disease are reviewed, with special focus on the diagnosis, classification and treatment. […] Morphea treatment can be a challenge, since there is no medication considered to be the gold standard. In addition, the choice of treatment will depend on how active the disease is, its extent, localization, depth and progression; i.e., it will be individualized to each patient. […] Treatment should be started early, before the appearance of complications in patients with risk associated with the morphea characteristics.

• #25 Morphea: progress to date and the road ahead

  https://atm.amegroups.org/article/view/61306/html

  The most widely investigated systemic therapies include combinations of methotrexate and corticosteroids. […] Mycophenolate mofetil is an emerging alternative to methotrexate for those who cannot tolerate or have contraindications to methotrexate. […] Damage that results after active lesions progress to an inactive state include atrophy, pigment changes and functional impairment. […] It is important to refer these patients to physical therapy, occupational therapy or specialties such as rheumatology or orthopedics early in order to reduce disability. […] Overall, the extracutaneous manifestations of morphea have not yet been systematically studied. […] The diagnosis of morphea can typically be made based on clinical findings, however biopsy of the lesions and imaging can help confirm the diagnosis or exclude other diagnoses. […] There remains a critical need to define morphea pathogenesis more clearly in order to identify promising targets for mechanistic studies and therapeutic development.

• #26

  https://link.springer.com/article/10.1007/s40257-017-0269-x

  The localized scleroderma cutaneous assessment tool (LoSCAT) has been developed and validated for morphea. […] This review provides two state-of-the-art algorithms that guide care providers with regard to (i) diagnostic work-up and disease monitoring, and (ii) treatment of morphea and eosinophilic fasciitis.

• #27

  https://journals.lww.com/idoj/fulltext/2020/11020/update_on_management_of_morphea__localized.1.aspx

  Juvenile localized scleroderma (morphea) is the predominant scleroderma in childhood which affects the skin and may extend to the underlying fascia, muscle, joints and bone. The assessment of activity and damage can be done with a validated instrument like LoSCAT. Disease classified as low severity which includes superficial plaque morphea can be treated with topical mid potent- potent steroids, tacrolimus, calcipotriol or imiquimod in combination with phototherapy. Methotrexate is recommended for linear, deep and generalized morphea. Steroids are effective in the early inflammatory stage and used in combination with methotrexate. Methotrexate is continued for at least 12 months after adequate response is achieved. Mycophenolate mofetil is given in cases where methotrexate is contraindicated or for those who do not respond to methotrexate. There are also reports of improvement of disease with ciclosporine and hydroxychloroquine. In severe cases, recalcitrant to standard therapy there may be a role for biologics, JAK inhibitors, and IVIG. Supportive measures like physiotherapy and psychiatric counseling are also important in the management of morphea. Orthopedic surgery and other measures like autologous fat transfer may be advocated once the disease is inactive.

• #28 Morphea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559010/

  Morphea, also called localized scleroderma, is a rare inflammatory skin condition that can also affect the subcutaneous tissues. […] This activity reviews the evaluation and treatment of morphea and highlights the role of the interprofessional team in caring for patients with this condition. […] Outline the importance of improving care coordination amongst the interprofessional team to enhance the care of patients with morphea. […] Clinicians should review the subtype of morphea, the depth of involvement, and disease activity, which play a significant role in treatment decisions. Early diagnosis and treatment are necessary to minimize damage such as cosmetic sequelae and joint contractures or limb deformities in patients with severe forms of morphea. […] A coordinated effort of health care providers that includes primary clinicians, dermatologists, and rheumatologists is necessary for early diagnosis and treatment. It is essential to do appropriate testing to differentiate morphea from systemic sclerosis, which has a poor prognosis due to systemic organ involvement. […] Patient education helps them to make informed decisions about the treatment options and prognosis of morphea.

• #29 Scleroderma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/scleroderma/?srsltid=AfmBOopmJ9V4O8zNhUzwtu652Oc7L9saMlWqL6wAhVDVQJ6YE1Ocxmjv

  Scleroderma is classified as an autoimmune rheumatic and connective tissue disease that causes inflammation and abnormalities in the affected body systems and tissues (Mecoli, 2020). […] Morphea (circumscribed and generalized) is one of the types of localized scleroderma. […] Management and treatments options are aimed towards symptom management and vary depending on the disease process specific to the individual. Management may involve pharmacological interventions, including (ACR, 2020): Anti-inflammatory drugs: Intravenous immunoglobin (IVIg) and/or immunosuppressive medications for muscle pain/weakness. […] Use the nursing process to develop a plan of care for individuals. […] Appropriate interventions will be determined by the site and severity of the individuals scleroderma but may include the following: Monitor: Vital signs, Efficacy of treatment, Intake and output, Neurological status, Cardiovascular status, Respiratory status, Pulse oximetry readings, Arterial blood gas (ABG).

• #30 03.07 Nursing Care and Pathophysiology for Scleroderma | Free NURSING.com Courses

  https://nursing.com/lesson/03-07-nursing-care-and-pathophysiology-for-scleroderma

  Pathophysiology: Scleroderma is caused by an autoimmune disorder where there is injury to the vascular injury and an increase in the amount of protein in the skin. This causes hardening and tightening of the skin. […] Morphea waxy patches on skin. […] We will assess this patients skin for morphea or linear scleroderma. Morphea are waxy patches on the skin, and linear scleroderma shows as streaks. […] The patient may have morphea which are waxy patches from the collagen buildup, or linear spots.

• #31 5 Ways to Relieve Morphea Itch | Morphea Treatment & Relief

  https://resources.healthgrades.com/right-care/skin-hair-and-nails/5-ways-to-relieve-morphea-itch

  Morphea is an autoimmune disease that causes hard, tight patches—also called lesions or plaques—on the skin. Morphea is a form of localized scleroderma that can affect only the top layer of skin, or it can penetrate the fat, muscles, joints or bones. While the condition is usually painless, the patches can become dry and itchy. Some people may choose not to treat the condition because it often goes away on its own within five years. Some morphea symptoms may be bothersome and can be treated. Morphea treatment won’t cure the condition. However, some treatments can reduce symptoms and provide morphea itch relief. […] Keeping the lesions moisturized can help relieve itching. Choose a thick cream rather than a lotion, and apply it twice a day for best results. A moisturizer with camphor and menthol can help cool your skin and relieve itch. In addition, try a warm (not hot) bath with baby oil or oatmeal to soothe your skin.

• #32 5 Ways to Relieve Morphea Itch | Morphea Treatment & Relief

  https://resources.healthgrades.com/right-care/skin-hair-and-nails/5-ways-to-relieve-morphea-itch

  Another inexpensive morphea treatment includes getting more sunlight. About 10 or 15 minutes several times a week can help reduce symptoms. Your skin makes vitamin D naturally when exposed to the sunlight which can help reduce inflammation. […] Phototherapy has a similar effect to getting outside in the sunlight. Ultraviolet light, specifically long-wavelength UVA (UVA1) or UVB, penetrates deeper into the skin to treat not only the visible lesions, but also underlying tissues, such as muscles and joints. Because phototherapy can help improve the lesions, it also helps relieve the itchiness they cause. […] You can request a prescription for a vitamin D cream or a corticosteroid cream that both work by reducing inflammation. By soothing inflammation, these creams offer morphea itch relief. […] Reducing itchy skin can start with some simple changes to avoid scratchy fabrics, drying agents (such as rubbing alcohol or harsh soaps), and fabric softener, which can irritate the skin. Take warm showers and baths; hot water tends to dry out the skin and can make itching worse.

• #33 Morphea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/morphea/diagnosis-treatment/drc-20375290

  For severe or widespread morphea, treatment may include the use of ultraviolet light (phototherapy). […] For severe or widespread morphea, your doctor may prescribe an immunosuppressive medication, such as oral methotrexate (Trexall), corticosteroid pills or both. […] If the condition affects your joints, physical therapy might preserve your range of motion. […] Because morphea dries the affected skin, moisturizers may help soften and improve the feel of your skin. […] Because morphea affects your appearance, it can be an especially difficult condition to live with. […] If you want counseling or support, ask your doctor for a referral to a mental health professional or information about support groups in your area or online. […] You may start by seeing your primary care doctor.

• #34

  https://journals.lww.com/idoj/fulltext/2020/11020/update_on_management_of_morphea__localized.1.aspx

  The aims of treatment are to arrest activity of disease, induce inactivity, prevent disfigurement, joint contractures and mobility restriction. […] The current recommendation for the management of moderate to severe morphea is methotrexate in combination with systemic steroids as an initial bridge therapy. In cases of resistance or failure of therapy, the options are mycophenolate mofetil, ciclosporine, and hydroxychloroquine. Phototherapy has a role in superficial morphea along with topical therapy but interference with the school schedule is a major deterrent to the routine use in children. Topical therapy with steroids, combination of calcipotriol-steroid (fixed-combination), or tacrolimus is used in limited disease.

• #35 Treating Pediatric Localized Scleroderma – National Scleroderma Foundation

  https://scleroderma.org/pediatric-treatments/

  To help determine the best treatment choice for your child, your pediatric rheumatologist and/or dermatologist may consider the following questions: Where are the lesions from localized scleroderma located? Is it near the head, joints, and/or cosmetically sensitive areas? […] Systemic medications are prescribed for children and teens with localized scleroderma who have deep tissue involvement, including extracutaneous involvement, and widespread involvement. […] There is no single, perfect therapy for all localized scleroderma patients. […] Systemic medications are prescribed for children and teens with localized scleroderma who have deep tissue involvement, including extracutaneous involvement, and widespread involvement. […] Physical and occupational therapy are important adjunct therapies for children who have functional impairment such as limited joint mobility, muscle weakness, or limb length differences from the disease.

• #36 Morphea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/morphea/diagnosis-treatment/drc-20375290

  For severe or widespread morphea, treatment may include the use of ultraviolet light (phototherapy). […] For severe or widespread morphea, your doctor may prescribe an immunosuppressive medication, such as oral methotrexate (Trexall), corticosteroid pills or both. […] If the condition affects your joints, physical therapy might preserve your range of motion. […] Because morphea dries the affected skin, moisturizers may help soften and improve the feel of your skin. […] Because morphea affects your appearance, it can be an especially difficult condition to live with. […] If you want counseling or support, ask your doctor for a referral to a mental health professional or information about support groups in your area or online. […] You may start by seeing your primary care doctor.

• #37 Morphea (Scleroderma): Treatment, Causes, and More

  https://www.verywellhealth.com/morphea-5179411

  Morphea, also sometimes called localized scleroderma, is a rare autoimmune disorder that causes skin thickening, hardening, and color changes. […] Unfortunately, we dont have a cure for morphea, but a variety of treatments can help lessen symptoms. Specific treatment will depend on the type and severity of morphea involved. […] People who have circumscribed morphea that just affects the outer layer of skin are usually prescribed ointments or creams. This is also true for people with linear morphea who only have skin symptoms. Such creams affect the immune response and modulate inflammation. […] Physical therapy and occupational therapy can be key for people who have joint contractures or deeper muscle and joint involvement. […] Morphea can have a significant psychological impact. Not surprisingly, people with more severe types of morphea tend to experience more problems related to this, and those with disfiguring disease may be most strongly affected. Professional counseling can be very helpful for people trying to navigate the disease.

• #38 Morphea | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25270

  Patient education helps them to make informed decisions about the treatment options and prognosis of morphea. Patients who are being prescribed medications like corticosteroids, methotrexate, and mycophenolate mofetil should be referred for pharmacy education about common side effects, contraception and medication interactions to improve compliance.

• #39 Scleroderma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/scleroderma/?srsltid=AfmBOopmJ9V4O8zNhUzwtu652Oc7L9saMlWqL6wAhVDVQJ6YE1Ocxmjv

  The individual will report and laboratory tests will confirm: Reduction of symptoms and/or little/no progression. […] Disease process: Various topics needed for adequate management include: Avoid cold and/or wet environments, Wear warm clothing, Importance of sunscreen, oral care, and stress management.

• #40 Morphea (localized scleroderma) in adults: Management – UpToDate

  https://www.uptodate.com/contents/morphea-localized-scleroderma-in-adults-management

  Morphea, also known as localized scleroderma, is an idiopathic inflammatory disorder that causes sclerotic changes in the skin. Affected patients present with single or multiple inflammatory and sclerotic plaques, findings considered manifestations of active disease. These plaques eventually become inactive, leaving permanent dermal or soft tissue atrophy and pigmentary changes (skin damage). […] There are multiple treatment options for active morphea; however, evidence in support of many of these therapies is limited. The majority of patients are managed with observation, topical medications, phototherapy, or systemic immunosuppressive therapy. The level of disease activity; depth of involvement; body surface area involved; and the presence of functional impairment, extracutaneous manifestations, or cosmetic disfigurement determine the most appropriate approach to treatment (algorithm 1).

• #41 Morphea: a practical review of its diagnosis, classification and treatment

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0016-38132019000500483

  Morphea, or localized scleroderma, is a rare disease of the connective tissue that manifests itself with localized sclerosis of the skin and, in some cases, with extracutaneous manifestations. […] Diagnosis and management of patients with morphea is not always easy and can be a challenge for the dermatologist. In this article, the basic concepts of the disease are reviewed, with special focus on the diagnosis, classification and treatment. […] Morphea treatment can be a challenge, since there is no medication considered to be the gold standard. In addition, the choice of treatment will depend on how active the disease is, its extent, localization, depth and progression; i.e., it will be individualized to each patient. […] Treatment should be started early, before the appearance of complications in patients with risk associated with the morphea characteristics.

• #42 Morphea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/morphea/diagnosis-treatment/drc-20375290

  Your doctor may diagnose morphea by examining the affected skin and asking about your signs and symptoms. […] It’s important to distinguish morphea from systemic scleroderma and other conditions. […] If your child has head and neck morphea, take him or her for regular comprehensive eye exams, as morphea may cause unnoticeable yet irreversible eye damage. […] Morphea usually lasts several years and then goes away without treatment. […] Until your condition clears up, you may want to pursue treatment that helps control your signs and symptoms. […] Treatment options vary depending on the extent of your condition and how it’s affecting your life. […] Your doctor may prescribe a vitamin D cream, such as calcipotriene, to help soften the skin patches. […] Or your doctor may prescribe a corticosteroid cream to reduce inflammation.

• #43 Morphea in Childhood: An Update | Actas Dermo-Sifiliográficas

  https://actasdermo.org/en-morphea-in-childhood-an-update-articulo-S157821901830088X

  There are numerous options for the treatment of morphea, including phototherapy, topical corticosteroids, topical calcipotriol, oral calcitriol, topical tacrolimus, systemic corticosteroids, methotrexate, mycophenolate mofetil, intralesional gamma interferon, ciclosporin A, D-penicillamine, imiquimod, bosentan, infliximab, etanercept, adalimumab, hydroxychloroquine, and photopheresis. […] The findings of numerous studies support the use of phototherapy in morphea; most of the evidence comes from uncontrolled, open-label studies and case series. […] Methotrexate (MTX) is often used to treat the different forms of morphea in childhood. […] The term morphea encompasses a broad spectrum of clinical forms which have considerable potential for causing long-term sequelae, making early diagnosis and appropriate treatment very important.

• #44 Morphea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/morphea/diagnosis-treatment/drc-20375290

  For severe or widespread morphea, treatment may include the use of ultraviolet light (phototherapy). […] For severe or widespread morphea, your doctor may prescribe an immunosuppressive medication, such as oral methotrexate (Trexall), corticosteroid pills or both. […] If the condition affects your joints, physical therapy might preserve your range of motion. […] Because morphea dries the affected skin, moisturizers may help soften and improve the feel of your skin. […] Because morphea affects your appearance, it can be an especially difficult condition to live with. […] If you want counseling or support, ask your doctor for a referral to a mental health professional or information about support groups in your area or online. […] You may start by seeing your primary care doctor.

• #45 Morphea (Localized Scleroderma) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/morphea-localized-scleroderma/

  Phototherapy (especially UVA1) […] Currently, phototherapy is one of the best treatment options in morphea when it does not involve subcutis or below. […] Methotrexate (MTX) is one of the best systemic treatment options for morphea. […] Topical steroids, although often prescribed, are of unclear benefit. Treating morphea at an early stage may require potent drugs or aggressive localized therapy to prevent spreading and progression. […] Every patient should undergo occupational therapy and physical therapy (OT/PT) if contractures or limited range of motion are present. […] There is one case report of a single patient with generalized morphea that is resistant to traditional therapy (including immunosuppression with cyclosporine), receiving imatinib. The off-label use of this tyrosine kinase inhibitor at a dose of 200mg per day for 6 months showed substantial improvement. After therapy cessation, no new lesions developed for 6 months. […] Currently there is no curative therapeutic approach available, and there is general agreement among morphea experts that the systemic therapies suppress disease activity, as evidenced by reports of disease reactivation after cessation of therapy.

• #46 Morphea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/morphea/diagnosis-treatment/drc-20375290

  For severe or widespread morphea, treatment may include the use of ultraviolet light (phototherapy). […] For severe or widespread morphea, your doctor may prescribe an immunosuppressive medication, such as oral methotrexate (Trexall), corticosteroid pills or both. […] If the condition affects your joints, physical therapy might preserve your range of motion. […] Because morphea dries the affected skin, moisturizers may help soften and improve the feel of your skin. […] Because morphea affects your appearance, it can be an especially difficult condition to live with. […] If you want counseling or support, ask your doctor for a referral to a mental health professional or information about support groups in your area or online. […] You may start by seeing your primary care doctor.

• #47 Update on Management of Morphea (Localized Scleroderma) in Children

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7247622/

  The aims of treatment are to arrest activity of disease, induce inactivity, prevent disfigurement, joint contractures and mobility restriction. […] The current recommendation for the management of moderate to severe morphea is methotrexate in combination with systemic steroids as an initial bridge therapy. […] In cases of resistance or failure of therapy, the options are mycophenolate mofetil, ciclosporine, and hydroxychloroquine. […] Topical therapy with steroids, combination of calcipotriol-steroid (fixed-combination), or tacrolimus is used in limited disease. […] Burnt out and inactive morphea does not require medical treatment but reconstructive surgery or autologous fat transfer, if feasible should be considered and patients referred to a plastic surgeon. […] Professional counseling by a psychologist will help those with cosmetically disfiguring disease.

• #48

  https://journals.lww.com/idoj/fulltext/2020/11020/update_on_management_of_morphea__localized.1.aspx

  The aims of treatment are to arrest activity of disease, induce inactivity, prevent disfigurement, joint contractures and mobility restriction. […] The current recommendation for the management of moderate to severe morphea is methotrexate in combination with systemic steroids as an initial bridge therapy. In cases of resistance or failure of therapy, the options are mycophenolate mofetil, ciclosporine, and hydroxychloroquine. Phototherapy has a role in superficial morphea along with topical therapy but interference with the school schedule is a major deterrent to the routine use in children. Topical therapy with steroids, combination of calcipotriol-steroid (fixed-combination), or tacrolimus is used in limited disease.

• #49 Scientists Identify Treatment Option for Rare Pansclerotic Morphea

  https://www.dermatologytimes.com/view/scientists-identify-treatment-option-for-rare-pansclerotic-morphea

  Scientists have found a new therapy for the severe inflammatory skin disorder. […] Scientists affiliated with the National Institutes of Health (NIH) and their colleagues have identified a potential treatment option for disabling pansclerotic morphea (DPM). […] DPM is a rare systemic inflammatory skin disorder associated with poor wound healing, squamous cell carcinoma, high rates of mortality, and more. […] Due to poor wound healing, patients skin and muscles become deeply scarred. […] Researchers previously thought that this disorder was caused by the immune system attacking the skin, said Sarah Blackstone in the press release. […] However, we found that this is an oversimplification, and that both skin and the immune system play an active role in disabling pansclerotic morphea.

• #50 What Is New in Morphea—Narrative Review on Molecular Aspects and New Targeted Therapies

  https://www.mdpi.com/2077-0383/13/23/7134

  Morphea, also known as localized scleroderma, is an autoimmune chronic connective tissue disease. It is characterized by excessive collagen deposition in the dermis and/or subcutaneous tissue. […] Understanding the pathogenesis of this disease is key to identifying potential new treatments. There are anecdotal reports of good therapeutic effects following the use of biological drugs such as tocilizumab, a humanized IgG monoclonal antibody; abatacept, a recombinant soluble fusion protein; JAK inhibitors, such as tofacitinib and baricitinib; and a drug used successfully in cancer treatment, imatinib, a tyrosine kinase receptor inhibitor. […] Depending on the clinical form of morphea, its activity or severity, the depth and extent of the lesions and the degree of tissue damage, local and systemic treatments are used in therapy.

• #51 What Is New in Morphea—Narrative Review on Molecular Aspects and New Targeted Therapies

  https://www.mdpi.com/2077-0383/13/23/7134

  In addition to the methods mentioned, we also have surgical procedures. […] As our understanding of the pathogenesis of this disease has progressed and genetic and autoimmune processes have been identified, we will focus on new therapeutic options using biological drugs, antifibrinolytic and small molecule agents.

• #52 Morphea – Cleaver Dermatology

  https://www.cleaverdermatology.com/morph-ea

  Physical therapy – This type of treatment uses stretching, strengthening and range-of-motion exercises to improve the mobility of your joints. […] Laser treatments, topical creams and chemical peels – These approaches help bring the look of natural color back to affected skin after the inflammation has subsided. […] Plastic surgery – Cosmetic surgery techniques may improve the look of discolored skin in highly visible places.

• #53

  https://journals.lww.com/idoj/fulltext/2020/11020/update_on_management_of_morphea__localized.1.aspx

  The aims of treatment are to arrest activity of disease, induce inactivity, prevent disfigurement, joint contractures and mobility restriction. […] The current recommendation for the management of moderate to severe morphea is methotrexate in combination with systemic steroids as an initial bridge therapy. In cases of resistance or failure of therapy, the options are mycophenolate mofetil, ciclosporine, and hydroxychloroquine. Phototherapy has a role in superficial morphea along with topical therapy but interference with the school schedule is a major deterrent to the routine use in children. Topical therapy with steroids, combination of calcipotriol-steroid (fixed-combination), or tacrolimus is used in limited disease.

• #54 Update on Management of Morphea (Localized Scleroderma) in Children

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7247622/

  The aims of treatment are to arrest activity of disease, induce inactivity, prevent disfigurement, joint contractures and mobility restriction. […] The current recommendation for the management of moderate to severe morphea is methotrexate in combination with systemic steroids as an initial bridge therapy. […] In cases of resistance or failure of therapy, the options are mycophenolate mofetil, ciclosporine, and hydroxychloroquine. […] Topical therapy with steroids, combination of calcipotriol-steroid (fixed-combination), or tacrolimus is used in limited disease. […] Burnt out and inactive morphea does not require medical treatment but reconstructive surgery or autologous fat transfer, if feasible should be considered and patients referred to a plastic surgeon. […] Professional counseling by a psychologist will help those with cosmetically disfiguring disease.

• #55 Treating Pediatric Localized Scleroderma – National Scleroderma Foundation

  https://scleroderma.org/pediatric-treatments/

  Orthopedic surgical interventions may be considered in children with localized scleroderma that have developed problems with their joints or limbs. […] Monitoring During Ongoing Treatment […] It is important to see your doctors regularly during treatment, which may mean visits every 1-3 months when the disease is active, and less when the disease is considered to be in remission.

• #56 Morphoea (localised scleroderma, morphea)

  https://dermnetnz.org/topics/morphoea

  Morphoea may be asymptomatic, or symptoms may arise from the skin or deeper tissues, or they may due to extracutaneous manifestations. […] Up to 30% of patients with more severe types of linear or generalised morphoea can have extracutaneous non-specific inflammatory symptoms. […] The diagnosis of morphoea is often made clinically, without the need for further tests. […] There is no cure for morphoea. Treatment is aimed at halting ongoing disease activity and progression. […] Specific treatment decisions in morphoea are guided by the subtype of morphoea and its severity. […] Disease progression and treatment response can be monitored using photographs, the localized scleroderma cutaneous assessment tool (LoSCAT) and other highly specialised tests. […] Morphoea can follow a protracted course, which can be relapsing and remitting, or chronically active. Milder forms of the disease tend to become inactive within 3 to 5 years.

• #57 Morphea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559010/

  Morphea, also called localized scleroderma, is a rare inflammatory skin condition that can also affect the subcutaneous tissues. […] This activity reviews the evaluation and treatment of morphea and highlights the role of the interprofessional team in caring for patients with this condition. […] Outline the importance of improving care coordination amongst the interprofessional team to enhance the care of patients with morphea. […] Clinicians should review the subtype of morphea, the depth of involvement, and disease activity, which play a significant role in treatment decisions. Early diagnosis and treatment are necessary to minimize damage such as cosmetic sequelae and joint contractures or limb deformities in patients with severe forms of morphea. […] A coordinated effort of health care providers that includes primary clinicians, dermatologists, and rheumatologists is necessary for early diagnosis and treatment. It is essential to do appropriate testing to differentiate morphea from systemic sclerosis, which has a poor prognosis due to systemic organ involvement. […] Patient education helps them to make informed decisions about the treatment options and prognosis of morphea.

• #58 Pathology Outlines – Morphea and systemic sclerosis

  https://www.pathologyoutlines.com/topic/skinnontumorscleroderma.html

  Morphea and systemic sclerosis are rare autoimmune fibrosing entities subtyped based on clinical presentation. […] Dysregulation of collagen synthesis and degradation causes vascular and immune dysfunction, leading to organ damaging fibrosis. […] Localized scleroderma (morphea) is divided into limited/circumscribed, generalized, linear, deep, and mixed types. […] Systemic sclerosis includes limited cutaneous systemic sclerosis, diffuse cutaneous systemic sclerosis, and systemic sclerosis sine scleroderma. […] The clinical features of localized scleroderma include skin thickening and potential involvement of underlying tissues. […] Systemic sclerosis can lead to significant complications affecting the skin, lungs, heart, and kidneys. […] Multidisciplinary care is required due to the involvement of several organs in systemic sclerosis. […] Treatment for localized scleroderma may include topical therapy, systemic therapy, phototherapy, physical therapy, and surgical interventions. […] For systemic sclerosis, an organ-based approach is necessary to determine organ involvement and disease activity.

• #59 Morphea // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/morphea

  Morphea usually improves on its own over time, though recurrences are common. […] Morphea affects the skin and underlying tissue and sometimes bone. […] Morphea can cause a number of complications, including self-esteem issues. […] Morphea usually lasts several years and then goes away without treatment. […] Treatment options vary depending on the extent of your condition and how it’s affecting your life. […] Because morphea dries the affected skin, moisturizers may help soften and improve the feel of your skin. […] If you want counseling or support, ask your doctor for a referral to a mental health professional or information about support groups in your area or online. […] You may start by seeing your primary care doctor. He or she may refer you to a doctor who specializes in skin disorders (dermatologist) or a specialist in diseases of the joints, bones and muscles (rheumatologist).

• #60 Morphea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559010/

  Morphea, also called localized scleroderma, is a rare inflammatory skin condition that can also affect the subcutaneous tissues. […] This activity reviews the evaluation and treatment of morphea and highlights the role of the interprofessional team in caring for patients with this condition. […] Outline the importance of improving care coordination amongst the interprofessional team to enhance the care of patients with morphea. […] Clinicians should review the subtype of morphea, the depth of involvement, and disease activity, which play a significant role in treatment decisions. Early diagnosis and treatment are necessary to minimize damage such as cosmetic sequelae and joint contractures or limb deformities in patients with severe forms of morphea. […] A coordinated effort of health care providers that includes primary clinicians, dermatologists, and rheumatologists is necessary for early diagnosis and treatment. It is essential to do appropriate testing to differentiate morphea from systemic sclerosis, which has a poor prognosis due to systemic organ involvement. […] Patient education helps them to make informed decisions about the treatment options and prognosis of morphea.

• #61 Morphea | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25270

  Morphea, also referred to as localized scleroderma, is a rare inflammatory disease of the skin and subcutaneous tissue. Morphea symptoms are usually limited to the skin and the subcutaneous tissue. Still, extracutaneous involvement is reported in approximately 22% of patients, with linear and generalized subtypes in a cohort reported by Zulian et al. Localized scleroderma can rarely cause debilitating lesions, which result in joint contractures, limb growth defects, and other extracutaneous features in children. […] Clinicians should review the subtype of morphea, the depth of involvement, and disease activity, which play a significant role in treatment decisions. Early diagnosis and treatment are necessary to minimize damage such as cosmetic sequelae and joint contractures or limb deformities in patients with severe forms of morphea.

• #62 Morphea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559010/

  Morphea, also called localized scleroderma, is a rare inflammatory skin condition that can also affect the subcutaneous tissues. […] This activity reviews the evaluation and treatment of morphea and highlights the role of the interprofessional team in caring for patients with this condition. […] Outline the importance of improving care coordination amongst the interprofessional team to enhance the care of patients with morphea. […] Clinicians should review the subtype of morphea, the depth of involvement, and disease activity, which play a significant role in treatment decisions. Early diagnosis and treatment are necessary to minimize damage such as cosmetic sequelae and joint contractures or limb deformities in patients with severe forms of morphea. […] A coordinated effort of health care providers that includes primary clinicians, dermatologists, and rheumatologists is necessary for early diagnosis and treatment. It is essential to do appropriate testing to differentiate morphea from systemic sclerosis, which has a poor prognosis due to systemic organ involvement. […] Patient education helps them to make informed decisions about the treatment options and prognosis of morphea.

• #63 This Is Caring: Enhancing Patient Education Materials for Individuals with Morphea Through Qualitative Inquiry – ACR Meeting Abstracts

  https://acrabstracts.org/abstract/this-is-caring-enhancing-patient-education-materials-for-individuals-with-morphea-through-qualitative-inquiry/

  This study determined patients experiences with localized scleroderma and their preferences for educational materials, with the goal of improving the quality and relevance of PEMs for this condition. […] The study highlights the role PEMs play in building patient-clinician relationships and the current information seeking behaviors of patients with localized scleroderma. Insights from patient experiences can guide the enhancement of educational materials, ensuring they meet the specific needs of individuals with localized scleroderma.

• #64 Morphea: Symptoms, Causes, and Treatments

  https://www.healthline.com/health/morphea

  Children with morphea on their head and neck should see an ophthalmologist, a specialist in eye problems, for regular eye exams. […] Most cases of morphea slowly go away on their own over time and dont alter a persons life expectancy. On average, a lesion lasts three to five years, but discoloration might persist for a few more years. […] Linear and deep morphea can interfere with the growth of children and lead to further problems, including differences in limb length, stiff and weak limbs, eye damage, and even death, but this is considered quite rare.

• #65 Morphea | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25270

  Morphea, also referred to as localized scleroderma, is a rare inflammatory disease of the skin and subcutaneous tissue. Morphea symptoms are usually limited to the skin and the subcutaneous tissue. Still, extracutaneous involvement is reported in approximately 22% of patients, with linear and generalized subtypes in a cohort reported by Zulian et al. Localized scleroderma can rarely cause debilitating lesions, which result in joint contractures, limb growth defects, and other extracutaneous features in children. […] Clinicians should review the subtype of morphea, the depth of involvement, and disease activity, which play a significant role in treatment decisions. Early diagnosis and treatment are necessary to minimize damage such as cosmetic sequelae and joint contractures or limb deformities in patients with severe forms of morphea.

• #66 Morphea | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25270

  Patient education helps them to make informed decisions about the treatment options and prognosis of morphea. Patients who are being prescribed medications like corticosteroids, methotrexate, and mycophenolate mofetil should be referred for pharmacy education about common side effects, contraception and medication interactions to improve compliance.

• #67 5 Ways to Relieve Morphea Itch | Morphea Treatment & Relief

  https://resources.healthgrades.com/right-care/skin-hair-and-nails/5-ways-to-relieve-morphea-itch

  Morphea is an autoimmune disease that causes hard, tight patches—also called lesions or plaques—on the skin. Morphea is a form of localized scleroderma that can affect only the top layer of skin, or it can penetrate the fat, muscles, joints or bones. While the condition is usually painless, the patches can become dry and itchy. Some people may choose not to treat the condition because it often goes away on its own within five years. Some morphea symptoms may be bothersome and can be treated. Morphea treatment won’t cure the condition. However, some treatments can reduce symptoms and provide morphea itch relief. […] Keeping the lesions moisturized can help relieve itching. Choose a thick cream rather than a lotion, and apply it twice a day for best results. A moisturizer with camphor and menthol can help cool your skin and relieve itch. In addition, try a warm (not hot) bath with baby oil or oatmeal to soothe your skin.

• #68 Scleroderma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/scleroderma/?srsltid=AfmBOopmJ9V4O8zNhUzwtu652Oc7L9saMlWqL6wAhVDVQJ6YE1Ocxmjv

  The individual will report and laboratory tests will confirm: Reduction of symptoms and/or little/no progression. […] Disease process: Various topics needed for adequate management include: Avoid cold and/or wet environments, Wear warm clothing, Importance of sunscreen, oral care, and stress management.

• #69 Scleroderma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/scleroderma/?srsltid=AfmBOopmJ9V4O8zNhUzwtu652Oc7L9saMlWqL6wAhVDVQJ6YE1Ocxmjv

  The individual will report and laboratory tests will confirm: Reduction of symptoms and/or little/no progression. […] Disease process: Various topics needed for adequate management include: Avoid cold and/or wet environments, Wear warm clothing, Importance of sunscreen, oral care, and stress management.

• #70 Morphea: Symptoms, Causes, and Treatments

  https://www.healthline.com/health/morphea

  Children with morphea on their head and neck should see an ophthalmologist, a specialist in eye problems, for regular eye exams. […] Most cases of morphea slowly go away on their own over time and dont alter a persons life expectancy. On average, a lesion lasts three to five years, but discoloration might persist for a few more years. […] Linear and deep morphea can interfere with the growth of children and lead to further problems, including differences in limb length, stiff and weak limbs, eye damage, and even death, but this is considered quite rare.

• #71 Morphea: Symptoms, Causes, and Effective Treatment Options – The Kingsley Clinic

  https://thekingsleyclinic.com/resources/morphea-symptoms-causes-and-effective-treatment-options/

  Morphea is a rare autoimmune skin condition that causes localized patches of hardened skin and, in some cases, affects the tissues beneath the skin. […] This article provides a comprehensive guide to Morphea, exploring its risk factors, symptoms, diagnostic methods, treatment approaches, and self-care strategies. […] Understanding the condition is an essential step toward effective management. […] In addition to medical treatments, incorporating specific home remedies can help manage Morphea symptoms and promote healthier skin. […] If you notice new or worsening symptoms, such as rapid plaque growth, pain, or joint stiffness, it’s important to seek medical attention promptly. […] By combining medical treatments, home remedies, and lifestyle adjustments, many individuals experience significant improvements in their condition.

• #72 Morphea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/morphea/diagnosis-treatment/drc-20375290

  For severe or widespread morphea, treatment may include the use of ultraviolet light (phototherapy). […] For severe or widespread morphea, your doctor may prescribe an immunosuppressive medication, such as oral methotrexate (Trexall), corticosteroid pills or both. […] If the condition affects your joints, physical therapy might preserve your range of motion. […] Because morphea dries the affected skin, moisturizers may help soften and improve the feel of your skin. […] Because morphea affects your appearance, it can be an especially difficult condition to live with. […] If you want counseling or support, ask your doctor for a referral to a mental health professional or information about support groups in your area or online. […] You may start by seeing your primary care doctor.

• #73 Morphea (Scleroderma): Treatment, Causes, and More

  https://www.verywellhealth.com/morphea-5179411

  Morphea, also sometimes called localized scleroderma, is a rare autoimmune disorder that causes skin thickening, hardening, and color changes. […] Unfortunately, we dont have a cure for morphea, but a variety of treatments can help lessen symptoms. Specific treatment will depend on the type and severity of morphea involved. […] People who have circumscribed morphea that just affects the outer layer of skin are usually prescribed ointments or creams. This is also true for people with linear morphea who only have skin symptoms. Such creams affect the immune response and modulate inflammation. […] Physical therapy and occupational therapy can be key for people who have joint contractures or deeper muscle and joint involvement. […] Morphea can have a significant psychological impact. Not surprisingly, people with more severe types of morphea tend to experience more problems related to this, and those with disfiguring disease may be most strongly affected. Professional counseling can be very helpful for people trying to navigate the disease.

• #74 Morphoea (localised scleroderma, morphea)

  https://dermnetnz.org/topics/morphoea

  Morphoea may be asymptomatic, or symptoms may arise from the skin or deeper tissues, or they may due to extracutaneous manifestations. […] Up to 30% of patients with more severe types of linear or generalised morphoea can have extracutaneous non-specific inflammatory symptoms. […] The diagnosis of morphoea is often made clinically, without the need for further tests. […] There is no cure for morphoea. Treatment is aimed at halting ongoing disease activity and progression. […] Specific treatment decisions in morphoea are guided by the subtype of morphoea and its severity. […] Disease progression and treatment response can be monitored using photographs, the localized scleroderma cutaneous assessment tool (LoSCAT) and other highly specialised tests. […] Morphoea can follow a protracted course, which can be relapsing and remitting, or chronically active. Milder forms of the disease tend to become inactive within 3 to 5 years.

• #75 Morphea: a practical review of its diagnosis, classification and treatment

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0016-38132019000500483

  Topical treatment is limited to the superficial and circumscribed varieties of morphea, without any movement or growth restriction. […] Systemic treatment should be used in linear morphea in the head and extremities with potential functional or cosmetic disability, in generalized or rapidly progressive lesions and in pan-sclerotic morphea. […] Physiotherapy is mandatory in patients in whom morphea causes mobility alterations or disability it is considered part of the treatment in patients with linear morphea in extremities or extensive lesions, to preserve the degree of mobility and minimize contractures, although its effectiveness has never been studied. […] The prognosis of circumscribed or superficial morphea is good, although the disease shows a tendency towards progression. Generally, the disease is inactivated in between three and five years, but approximately 30 % of patients will experience relapses, especially if morphea started in childhood and if treatment was not adequate.

• #76 Morphea: a practical review of its diagnosis, classification and treatment

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0016-38132019000500483

  Topical treatment is limited to the superficial and circumscribed varieties of morphea, without any movement or growth restriction. […] Systemic treatment should be used in linear morphea in the head and extremities with potential functional or cosmetic disability, in generalized or rapidly progressive lesions and in pan-sclerotic morphea. […] Physiotherapy is mandatory in patients in whom morphea causes mobility alterations or disability it is considered part of the treatment in patients with linear morphea in extremities or extensive lesions, to preserve the degree of mobility and minimize contractures, although its effectiveness has never been studied. […] The prognosis of circumscribed or superficial morphea is good, although the disease shows a tendency towards progression. Generally, the disease is inactivated in between three and five years, but approximately 30 % of patients will experience relapses, especially if morphea started in childhood and if treatment was not adequate.

• #77 Morphea: Symptoms, Causes, and Treatments

  https://www.healthline.com/health/morphea

  Children with morphea on their head and neck should see an ophthalmologist, a specialist in eye problems, for regular eye exams. […] Most cases of morphea slowly go away on their own over time and dont alter a persons life expectancy. On average, a lesion lasts three to five years, but discoloration might persist for a few more years. […] Linear and deep morphea can interfere with the growth of children and lead to further problems, including differences in limb length, stiff and weak limbs, eye damage, and even death, but this is considered quite rare.

• #78 Treating Pediatric Localized Scleroderma – National Scleroderma Foundation

  https://scleroderma.org/pediatric-treatments/

  Orthopedic surgical interventions may be considered in children with localized scleroderma that have developed problems with their joints or limbs. […] Monitoring During Ongoing Treatment […] It is important to see your doctors regularly during treatment, which may mean visits every 1-3 months when the disease is active, and less when the disease is considered to be in remission.

• #79 03.07 Nursing Care and Pathophysiology for Scleroderma | Free NURSING.com Courses

  https://nursing.com/lesson/03-07-nursing-care-and-pathophysiology-for-scleroderma

  Pathophysiology: Scleroderma is caused by an autoimmune disorder where there is injury to the vascular injury and an increase in the amount of protein in the skin. This causes hardening and tightening of the skin. […] Morphea waxy patches on skin. […] We will assess this patients skin for morphea or linear scleroderma. Morphea are waxy patches on the skin, and linear scleroderma shows as streaks. […] The patient may have morphea which are waxy patches from the collagen buildup, or linear spots.

• #80 Scleroderma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/scleroderma/?srsltid=AfmBOopmJ9V4O8zNhUzwtu652Oc7L9saMlWqL6wAhVDVQJ6YE1Ocxmjv

  Scleroderma is classified as an autoimmune rheumatic and connective tissue disease that causes inflammation and abnormalities in the affected body systems and tissues (Mecoli, 2020). […] Morphea (circumscribed and generalized) is one of the types of localized scleroderma. […] Management and treatments options are aimed towards symptom management and vary depending on the disease process specific to the individual. Management may involve pharmacological interventions, including (ACR, 2020): Anti-inflammatory drugs: Intravenous immunoglobin (IVIg) and/or immunosuppressive medications for muscle pain/weakness. […] Use the nursing process to develop a plan of care for individuals. […] Appropriate interventions will be determined by the site and severity of the individuals scleroderma but may include the following: Monitor: Vital signs, Efficacy of treatment, Intake and output, Neurological status, Cardiovascular status, Respiratory status, Pulse oximetry readings, Arterial blood gas (ABG).

• #81 Scleroderma: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/scleroderma/?srsltid=AfmBOopmJ9V4O8zNhUzwtu652Oc7L9saMlWqL6wAhVDVQJ6YE1Ocxmjv

  Scleroderma is classified as an autoimmune rheumatic and connective tissue disease that causes inflammation and abnormalities in the affected body systems and tissues (Mecoli, 2020). […] Morphea (circumscribed and generalized) is one of the types of localized scleroderma. […] Management and treatments options are aimed towards symptom management and vary depending on the disease process specific to the individual. Management may involve pharmacological interventions, including (ACR, 2020): Anti-inflammatory drugs: Intravenous immunoglobin (IVIg) and/or immunosuppressive medications for muscle pain/weakness. […] Use the nursing process to develop a plan of care for individuals. […] Appropriate interventions will be determined by the site and severity of the individuals scleroderma but may include the following: Monitor: Vital signs, Efficacy of treatment, Intake and output, Neurological status, Cardiovascular status, Respiratory status, Pulse oximetry readings, Arterial blood gas (ABG).

• #82 Morphea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559010/

  Morphea, also called localized scleroderma, is a rare inflammatory skin condition that can also affect the subcutaneous tissues. […] This activity reviews the evaluation and treatment of morphea and highlights the role of the interprofessional team in caring for patients with this condition. […] Outline the importance of improving care coordination amongst the interprofessional team to enhance the care of patients with morphea. […] Clinicians should review the subtype of morphea, the depth of involvement, and disease activity, which play a significant role in treatment decisions. Early diagnosis and treatment are necessary to minimize damage such as cosmetic sequelae and joint contractures or limb deformities in patients with severe forms of morphea. […] A coordinated effort of health care providers that includes primary clinicians, dermatologists, and rheumatologists is necessary for early diagnosis and treatment. It is essential to do appropriate testing to differentiate morphea from systemic sclerosis, which has a poor prognosis due to systemic organ involvement. […] Patient education helps them to make informed decisions about the treatment options and prognosis of morphea.

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