Understanding Localised Scleroderma
Localised scleroderma, also known as morphea, is an autoimmune disease where the immune system attacks the skin and underlying tissues, leading to hard, tight, and shiny patches.
Unlike systemic scleroderma, this condition does not affect internal organs. It often appears in school-aged children and adolescents, more commonly in girls.
Types of Localised Scleroderma
- Plaque Morphea: Round or oval patches on the skin.
- Linear Scleroderma: A single thickened line, often on limbs or the face.
- Generalised Morphea: Multiple widespread patches.
- En Coup de Sabre: Linear lesion on the forehead or scalp resembling a scar from a sword cut.
Common Signs and Symptoms
- Skin thickening and tightness
- Discolored patches (white, shiny, or purple)
- Hair loss over affected area
- Restricted movement if joints are involved
- Facial asymmetry in En Coup de Sabre type
Red Flags
- Skin patches that are getting larger or harder
- Facial changes or deformities
- Stiffness or pain in nearby joints
- Skin lesions near the eyes or scalp
Diagnosis
- Clinical Examination
Typical appearance often leads to diagnosis.
- Imaging and Tests
- MRI: To assess deeper tissue involvement.
- Blood tests: May show autoimmune activity (ANA).
- Skin biopsy: Confirms diagnosis.
Treatment and Management
Medications
- Topical corticosteroids or tacrolimus for mild cases.
- Methotrexate and systemic steroids for progressive or deep lesions.
- Physical therapy to maintain mobility.
Skincare and Sun Protection
- Use gentle moisturizers and avoid trauma to the skin.
- Sunscreen helps prevent pigmentation changes.
Why Early Treatment is Crucial
Prompt therapy can halt disease progression, prevent joint contractures, and minimize cosmetic disfigurement, especially in facial or limb involvement.
Hope Arthritis Foundation’s Role
Through public education and community clinics, we promote awareness that skin changes in children can signal autoimmune disease. Early detection leads to better cosmetic and functional outcomes.
Written by:
Dr. Angela Migowa, MD, MMed, Paediatric Rheumatology,PhD
Pediatric Rheumatologist & Founder, Hope Arthritis Foundation