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- Jorja on UVB NB vs PUVA Treatment for Mycosis Fungoides.
- Chris Cane on Granuloma Annulare Can it be treated with Narrow Band UVB Therapy?
- Chris Cane on Granuloma Annulare Can it be treated with Narrow Band UVB Therapy?
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Link Category
Morphea – Some Background Information
Author: Jennifer V Nguyen, MD, Resident Physician, Department of Dermatology, Hospital of the University of Pennsylvania
Coauthor(s): Victoria P Werth, MD, Professor of Dermatology and Medicine, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, Philadelphia Veterans Affairs Medical Center; Nicole Fett, MD, Clinical Educator, Department of Dermatology, University of Pennsylvania School of Medicine
Morphea, also known as localized scleroderma, is a disorder characterized by excessive collagen deposition leading to thickening of the dermis, subcutaneous tissues, or both. Morphea is classified into plaque, generalized, linear, and deep subtypes according to the clinical presentation and depth of tissue involvement. Unlike systemic sclerosis, morphea lacks features such as sclerodactyly, Raynaud phenomenon, nailfold capillary changes, telangiectasias, or progressive internal organ involvement. Morphea can present with extracutaneous manifestations, including fever, lymphadenopathy, arthralgias, and central nervous system involvement, and laboratory abnormalities, including eosinophilia, polyclonal hypergammaglobulinemia, and positive antinuclear antibodies.1,2,3
Although rare, epidemiologic studies suggest 0.9-5.7% of patients with morphea progress to systemic scleroderma.2 The transition may be marked by the development of Raynaud phenomenon and nailfold capillary changes.
It would be silly and foolhardy of me to copy the entire article from the eMedicine website.
The article in its entirety can be found at http://emedicine.medscape.com/article/1065782-overview
This article links to http://emedicine.medscape.com/article/1065782-treatment
Amongst other treatments the article discusses:
UVA and UVA-1 Broadband UVA (320-400 nm, low-dose), long-wavelength UVA (UVA1; 340-400 nm, low- or medium-dose), and psoralen plus UVA (oral or bath) photochemotherapy have produced marked clinical improvement of morphea lesions in multiple case series and a randomized controlled trial. Because UVA1 wavelengths penetrate deeper into the dermis, this modality is particularly effective in the treatment of morphea. Low-, medium-, and high-dose UVA are all effective. Medium-dose UVA1 provides for better long-term results than low-dose UVA1 in morphea as shown by ultrasound assessment.26 Unfortunately, the availability of UVA1 is currently limited. Narrowband UVB therapy, although less potent owing to its limited dermal penetration, can also be beneficial. Regimens combining UV therapy with topical corticosteroids or calcipotriene may be superior to either method alone.42,43
To see the entire article on treatment at the eMedicine site, See http://emedicine.medscape.com/article/1065782-treatment









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