Morphea and Scleroderma

Morphea and scleroderma are a spectrum of autoimmune connective tissue disorders hallmarked by tissue fibrosis. Morphea is localized to the skin, subcutaneous tissues, and occasionally, deeper, directly underlying structures such as muscle and bone. In contrast, scleroderma is characterized by systemic involvement, including the vasculature and internal organs (1a) (Fett, Clin Dermatol 31:432–437, 2013). Treatment largely depends upon the extent of disease, with minor cases of morphea requiring observation and systemic sclerosis requiring potent immunosuppressive medications. Although an exhaustive discussion of medical therapies for this spectrum of diseases is beyond the scope of this chapter, surgeries and laser therapy are important components of comprehensive care of these patients. The cosmetic and functional sequelae of morphea and scleroderma can be extensive, and the procedural dermatologist is in a unique position to reverse some of the manifestations of these debilitating diseases.