Morphoea is a localized form of scleroderma with pale indurated plaques on the skin but no internal sclerosis (Figs 10.12 and 10.13). Many plaques are surrounded by a violaceous halo. Its prognosis is usu-ally good, and the fibrosis slowly clears leaving slight depression and hyperpigmentation. A rare type may lead to arrest of growth of the underlying bones caus-ing, for example, facial hemiatrophy or shortening of a limb. Little is known about the cause, except that Lyme borreliosis may be associated with the dis-ease in Europe but not in the Americas. Treatments work slowly, if at all, and include topical steroids, calcipotriene, non-steroidal anti-inflammatory drugs (NSAIDs), psoralen with ultraviolet A (PUVA), UVA and hydroxychloroquine in selected patients.
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