Localized Scleroderma

Scleroderma represents a general process of thickening and induration of the skin from excessive tissue deposition of collagen and other matrix proteins.In systemic sclerosis (progressive systemic sclerosis, scleroderma, generalized scleroderma), the symmetric cutaneous in duration is accompanied by internal organ involvement and potentially fatal complications.Localized scleroderma (morphea) refers to a distinct asymmetric process of induration and thickening limited (localized) to the skin and without internal organ involvement.Although often mild, localized scleroderma may cause life-long disabilities and severe disfigurement.Recognition of recently described prognostic factors provides guidelines for the management of these patients.This article will discuss the clinical features of localized scleroderma, its differentiation from other sclerosing conditions, prognostically useful laboratory abnormalities, and a perspective on treatment. CLINICAL FEATURES Morphologic VariantsWe recognize three main morphologic variants of localized scleroderma l2 , 13: morphea, generalized morphea, and linear scleroderma.Morphea is characterized by one or more circumscribed patches of skin in duration with varying degrees of pigment changes (Fig. 1).A violaceous or erythematous border is seen in some of the lesions that are still progressing.The morphea patches may be hyperpigmented or hypopigmented (or both), but in older lesions, a yellow hue may be present.Depending on their clinical appearance, some lesions of morphea are described as being "guttate" or resembling keloids. 23Morphea is more common on the trunk than on the extremities. 5When individual patches become confluent and affect a larger portion of the cutaneous surface, the