What is Morphea?
This is a rare skin disease that can lead to thickened discolored areas on the scalp that can be associated with hair loss. In addition to the scalp, it can basically occur anywhere on the body. One version of morphea tends to occur in a linear pattern and is referred to as Coup de Sabre or “blow of the sword”. The depressed crevice in this version can also be associated with hair loss.
What is the cause of Morphea?
The cause of Morphea is unknown.
What are the symptoms and findings?
The most characteristic distinction associated with morphea is that the involved area of skin becomes thickened and hardened. Various types of discoloration can occur in association with the thickness such as “a salt and pepper” speckled coloration, dark brownish-black hyperpigmentation, or reddish brown mixed with white coloration characteristic of poikiloderma. On the scalp there can also be hair loss in the areas of these thick patches.
How is it diagnosed?
The unique features of morphea usually require a skin biopsy to confirm the diagnosis.
What tests are needed?
In addition to a skin biopsy, blood tests might be done to check for any association of morphea with any other types of autoimmune conditions.
What is the expected duration?
It is hard to predict how long morphea will continue or how far it will progress. It can improve over time with medications or it can progress to involve larger areas of the scalp and cause permanent baldness.
How can it be prevented?
There is no known way to prevent Morphea
The treatment goal is to stop the inflammation of the skin and destruction of hair follicles. Localized treatment of small patches with topical or intralesional steroid injections can be of benefit. More extensive cases can require oral antimalarial medication such as hydroxychloroquine. With deeper tissue loss, fat grafting with or without Platelet Rich Plasma (PRP) can be useful to correct the deeper areas of sunken skin
When to contact a professional
At the first sign of any thickened or hard areas on the scalp with discolored skin, a dermatologist should be contacted.
Early treatment can reverse the inflammation and lead to regrowth of hair, but morphea is a chronic disease that can continue to progress in spite of treatment that can lead to permanent baldness on the scalp.