Q: I was diagnosed with morphea about three years ago. I understand there's no cure, but I'm looking at treatments to improve the condition. I know there's light therapy and I found some information on herbal medicines on the Internet. Are there any other safe, reliable treatments?
A: Morphea is a condition characterized by skin thickening. Often the appearance of a morphea lesion is an oval patch with a faint pink or yellow appearance and a faint purplish border. Over time, the area becomes smooth, shiny, and scar-like.
Your doctor can often diagnose morphea by examination alone, but a biopsy may be needed to confirm. The skin thickening may be superficial, or may involve underlying tissues, as well. Instead of an oval patch, it may look like a long, linear, scar-like depression in the skin.
Tiny cells called "fibroblasts" are responsible for producing collagen in skin. Collagen is a glue-like protein. In morphea, these fibroblasts work overtime, producing too much collagen. Possible reasons include:
--An autoimmune process
There's no optimum treatment for morphea. The skin changes will sometimes go away on their own over time. Treatment to reduce inflammation in early morphea is more successful than attempts to decrease scarring later on. Possible treatments of early morphea include the topical use of:
--Corticosteroid creams or ointments (many generic versions)
--Tacrolimus ointment (Protopic, generic versions)
--Imiquimod cream (Aldara, generic versions)
Light-based treatments, especially those utilizing UVA, may also be helpful.
In severe cases, oral (by mouth) steroids or methotrexate may be needed. If bone and joints are involved, surgery may be needed to release contractures (tight scars that prevent full extension of an arm or leg).
It's important to see your doctor for an evaluation of morphea and for treatment suggestions. These will vary depending upon the type of morphea you have.
(Rebecca Campen, M.D., J.D., is an assistant professor of dermatology at Harvard Medical School. She divides her time between clinical practice of dermatology at the Massachusetts General Hospital and private practice in Savannah, Ga.)
(For additional consumer health information, please visit www.health.harvard.edu.)
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