Morphea: clinical subtypes and management in a tertiary care hospital. A 12 years retrospective study

Abstract

Background: morphea is an inflammatory disease that primarily affects the skin and underlying tissues and results in their sclerosis. In Argentina, the statistical data on morpheas are unknown. Epidemiological studies in the United Kingdom and the United States establish that it is uncommon.

Objectives: to describe the epidemiological profile of the population diagnosed with morphea, including age, gender, types and subtypes of morphea, symptoms, associated diseases, laboratory parameters in periods of activity, and treatments performed.

Design: descriptive, observational, cross-sectional and retrospective study.

Materials and methods: analysis of medical records of patients aged 18 years or older with a diagnosis of morphea seen at the Dermatology Department of the Hospital General de Agudos José María Ramos Mejía in the Autonomous City of Buenos Aires between January 2011 and July 2023.

Results: the sample consisted of 45 patients. The median age at diagnosis was 26 years. Women accounted for 84.4%. The predominant type of morphea was linear (48.9%), followed by pansclerotic (15.6%) and circumscribed (13.3%). Within the linear type, limb morphea predominated, followed by Parry Romberg syndrome. The most frequent extracutaneous manifestation was arthralgia. Hashimoto's thyroiditis was an associated disease in 8.88% of patients. The 53.33% manifested activity parameters during follow-up. Of these, 45.8% showed elevated erythrocyte sedimentation rate. The most commonly used systemic treatment was methotrexate associated with intravenous corticosteroid pulses.

Conclusions: this is the most extensive case series of morphea published so far in Argentina. Women had a high prevalence, and the linear type was the most frequent. Although this work allows us to increase the national casuistry, the fact that the study was carried out in a third-level centre limits the extrapolation of the results to the general population of Argentina since the most severe and complex to manage cases are referred to this centre; therefore, it is essential to continue with future research.