Morphoea
is an uncommon condition presenting with firm white plaques in the skin. As
here there is often a purplish edge to the lesions. Morphoea is sometimes
called localised scleroderma but it is a separate condition and is not related
to the internal disorders induced by the auto antibodies produced with
scleroderma. Often patients have just two or three plaques of morphoea that
persist for several years and then resolve with softening of the skin and
hyperpigmentation where there was previously hypopigmentation. The firm texture
of the plaque is due to the laying down of excess collagen in the dermis. This
also causes the skin whiteness. Topical
steroids, calcineurin inhibitors such as Pimecrolimus and Tacrolimus and
topical Calcipotriol have all been tried to resolve these white plaques but
none can be enthusiastically recommended. There is a linear variant of this
condition that involves a sunken line on the forehead called en coup de sabre.
The cause is not known.
