Morphea

By Dr. Pascal Bafteh · last updated 09/2026

Overview

• No systemic involvement. Variants: Plaque morphea, linear morphea (en coup de sabre), generalized morphea.

• Morphea Dermoscopy: Fibrotic beams (white rays). Lilac ring = active border.
• Circumscribed Scleroderma en coup de sabre: Linear morphea in the forehead area. Can affect deeper structures (Parry-Romberg).
• Nailfold Capillaroscopy: In SSc megacapillaries + avascular areas. Earliest clinical marker.
• 20 MHz high-frequency ultrasound: The standard technique for measuring dermal thickness and echogenicity in morphea and systemic sclerosis — active lesions show a thickened, hypoechoic dermis, burnt-out atrophic lesions a thin, hyperechoic dermis, which makes the disease course measurable. The same 20 MHz technique is used preoperatively in melanoma to estimate tumour thickness for planning the excision margin; the sonographic thickness usually exceeds the histological Breslow thickness because the peritumoural inflammatory infiltrate is measured as well.

Differential diagnoses

• Limited systemic sclerosis (CREST syndrome)
• Scleredema Buschke
• Dermatomyositis
• Lichen sclerosus
• Sarcoidosis
• Psoriasis vulgaris (plaque psoriasis)
• Atypical fibroxanthoma
• Cutaneous angiosarcoma

Sources (selection)

1. Kreuter A, Krieg T, Worm M, et al. S2k-Leitlinie Diagnostik und Therapie der zirkumskripten Sklerodermie. AWMF-Register-Nr. 013-066. Stand 2023. Berlin: AWMF; 2023.

More connective tissue diseases

• Dermatomyositis
• Lupus erythematosus gesicht
• Relapsing polychondritis
• Raynaud syndrome

Note: This page is intended for medical education and does not replace diagnosis or treatment decisions in individual cases. Treatment and follow-up content is available in the app.