Morphea is an inflammatory skin condition caused by increased collagen deposition that leads to patches of thickened skin. It is also known as localized scleroderma and primarily appears on the chest, belly, and back. There are many forms of localized scleroderma, with the most common form in adults being limited-type plaque morphea. The most common type in children is called band-like cutaneous sclerosis and causes limb-length discrepancies and in some cases a mark on the face (Coup de sabre).

Limited-type plaque morphea (see illustration) on the trunk presents as painless, oval, and well circumscribed discolorations of 3-5 cm in size.

Patches of active inflammatory morphea have purple and reddish borders, known as a ‘lilac ring’. Skin may tighten or become firm, thick, dry, and shiny. Late stage lesions (inactive) show postinflammatory hyperpigmentation.

The precise cause of morphea is unknown, but an autoimmune mechanism is likely. Superficial morphea is a self-limited condition. Lesion activity lasts 3-5 years on average, but new lesions may occur over a patient’s lifetime.