Recent Developments in Diagnosis and Assessment of Morphea

Abstract

There is huge variation in the evaluation, diagnosis, and treatment of patients with morphea (localized scleroderma). In part, this variability results from the lack of validated methods to assess severity and outcomes with a consequent lack of adequate therapeutic trials. Evaluation is also hindered by lack of information regarding the impact of morphea on patients. Recent studies are addressing this gap in knowledge and include: development of clinical outcome measures, validation of imaging studies, publication of consensus treatment plans, and increased understanding of the impact of morphea on patients and parents. The purpose of this review is to summarize the results of these studies and to synthesize the information into a rational approach to the diagnosis and assessment of patients with morphea.

Lower limb linear morphoea in a pregnant woman with known Graves' disease and cytomegalovirus immunoglobulin M positivity

“…4 Although this condition does not increase mortality, it is associated with a significant amount of morbidity. 1,4 Immunohistochemically this is reflected by a decrease in CD34. Histologically, this is reflected by dermal perivascular lymphocytic infiltrates followed by thickened collagen bundles, atrophy of eccrine glands and loss of blood vessels.…”

“…1 Lesion location, treatment modality and timing play important roles in long-term morbidity. 1 Lesion location, treatment modality and timing play important roles in long-term morbidity.…”

Antiphospholipid antibodies in localized scleroderma: the potential role of screening tests for the detection of antiphospholipid syndrome

“…Reports exist about more than one case of LoS within a single family, which suggests that genetic factors play a role in its incidence [6]. Also, its coexistence with other autoimmune diseases suggests that a similar mechanism [2], and numerous autoantibodies have been associated with LoS, including antinuclear, anti-histone, and anti-ssDNA antibodies [7]. However, the clinical significance of autoantibody testing in scleroderma is unclear, as no association has been found between the presence of any autoantibody and disease activity.…”

“…However, the clinical significance of autoantibody testing in scleroderma is unclear, as no association has been found between the presence of any autoantibody and disease activity. Although the anti-histone and ssDNA antibodies may be useful as markers of disease severity in linear LoS, they are not associated with disease activity and are of limited clinical value due to their rarity [7]. …”

“…Recent reports note the presence of antiphospholipid antibodies (aPL) in as many as 70% of patients with LoS [7–10]. However, reports on the prevalence of antiphospholipid syndrome (APS) in patients with LoS are very rare [11, 12].…”