Morphea Differential Diagnoses

Updated: Jun 17, 2020
  • Author: Victoria P Werth, MD; Chief Editor: Dirk M Elston, MD  more...
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Diagnostic Considerations

Also consider the following:

  • Linear melorheostosis
  • Linear lupus erythematosus panniculitis
  • Linear atrophoderma of Moulin
  • Lipodermatosclerosis
  • Radiation fibrosis
  • Reflex sympathetic dystrophy
  • Scleromyxedema
  • Cheiroarthropathy due to diabetes mellitus
  • Carcinoid syndrome
  • Muckle-Wells syndrome
  • Stiff skin syndrome
  • Restrictive dermopathy
  • Progeria
  • Sclerodermoid conditions caused by chemical/toxin exposures (ie, polyvinyl chloride, epoxy resins, pesticides, dry cleaning solvents, silica dust)
  • Sclerodermoid conditions caused by iatrogenic agents (ie, bleomycin, taxanes, gemcitabine, uracil-tegafur, melphalan isolated limb perfusion, L-tryptophan, vitamin K injections, pentazocine injections, silicone or paraffin implants)

Some of the entities in the differential diagnosis above often manifest with a sclerodermoid (ie, diffuse sclerosis) rather than morpheaform (ie, discrete areas of sclerosis) morphology.

Atrophoderma of Pasini and Pierini and eosinophilic fasciitis are generally viewed as part of the morphea spectrum. [45] Lichen sclerosus and morphea can coexist, with clinical and histologic findings of both conditions present in the same patient and even within the same lesion. [42, 41] In addition, lichen sclerosus, discrete morpheaform plaques, diffuse sclerodermoid changes, and eosinophilic fasciitis all can occur as manifestations of chronic graft versus host disease.

The differential diagnosis for early, erythematous lesions of plaque-type morphea may include the following:

Differential Diagnoses