Clinical features and treatment of morphea patients: a retrospective analysis.

Abstract

Morphea is a rare inflammatory disease affecting the skin and connective tissue leading to sclerosis and atrophy. To analyse a cohort of adult patients suffering from morphea regarding demographics and clinical subtype. The medical records of patients (≥18 years old) diagnosed with morphea (L94.0 to L94.1) who presented at the Department of Dermatology, Venereology and Allergology at the Charité-Universitätsmedizin Berlin between 2017 and 2023 were assessed (n=479). Most patients were female (n=390; 81%), aged between 60 and 69 years (n=101; 21%). Unspecified morphea (n=232; 48%) was most commonly coded as multilocular morphea in 149 cases and linear morphea in 29 cases. The most frequently reported comorbidities were hypertension, diabetes mellitus, and hypothyroidism. Autoimmune diseases, such as genital lichen sclerosus, Sjögren's disease and rheumatoid arthritis, were also not infrequent. Antinuclear antibody (ANA) assessment was available for 105/128 patients; 56/105 patients had a positive ANA titre (at least 1:80). Overall, 68/128 patients were treated topically, while 47/128 patients received systemic treatment. Twelve patients were treated with two or more systemic therapies. Topical corticosteroids and methotrexate were most commonly used. Mild side effects occurred only in methotrexate-treated patients (n=6). Morphea is a heterogeneous clinical disease requiring individualised treatment depending on subtype and localisation. Defined severity criteria and standardised assessment tools are needed to identify patients who require systemic treatment and ensure that treatment efficacy is comparable among patients.