Morphea is a relatively rare disease that affect the skin and connective tissue with excessive collagen formation go to heavy and tight skin . It is a disease that is see in equal proportion in both adult and children , but women have a higher predilection than man . Although , the etiology of morphea still remain ill-defined , for the most part it is consider an autoimmune disorder with inherited predisposition , in addition to possible psychic trauma , contagion or beam of light trigger .
What Is The Best Medicine For Morphea?
There is no one good music for morphea and the handling is extremely individualized . The treatment should be start with topical medicines , but in rapidly reformist cases , topical medicine are not sufficient , so it mandate system of rules therapy , such as systemic corticoid and methotrexate as first line therapy .
Circumscribed or localized morphea have a less grievous course and settle spontaneously over a period of 3 - 5 age . This wound can be managed with less aggressive treatment mode , including topical therapy or phototherapy limited to the lesion . The wound are more antiphonal to treatment when they are in their active form ( < 3 calendar month of initiation ) . Topical or intralesional corticoid have been find helpful in reducing ignition and limit progression of the term . Topical tracrolimus 0.1 % and imiquimod 5 % have also been used with limited winner , in addition to topical occlusion calcipotriene , a vitamin D first derivative . Studies have found superior results with the combination of topical steroids or calcipotriene along with phototherapy than either of the intervention methods alone .
Phototherapyinvolves the picture of the lesion to UVA1 , PUVA and UVB broadband of wavelength , which have give very serious outcome . UVA1 penetrate the dermal layer to the subcutis , so it can be used as broken Cupid’s itch , medium dose and gamey dose depend on the inclemency and depth of the wound . PUVA is psoralen UVA , which is the combining usage of UVA1 phototherapy along with a chemical substance , psoralen that enhances the tegument predisposition to UVA actinotherapy .
generalise , pansclerotic and linear subtypes of morphea need an aggressive treatment sensory system , peculiarly depending on the extent of involvement of the deeper layer . More the involvement of deeper layers , more aggressive should be the handling . There have been report cases of success with the combination therapy of systemic corticosteroid , either monthly pulsed IV methylprednisolone or oral prednisone and hebdomadary amethopterin . This combining can be used in knockout or rapidly progressive form of morphea . backsliding is also common in the disease form , so to avoid that methotrexate discussion is recommend for at least 2 twelvemonth . Methotrexate resistive lesions should be treated with mycophenolate mofetil .
Although , systemic corticosteroids have been establish helpful for treatment of active phase of morphea , they are of footling avail when the condition is more established . They are also not recommended for prospicient full term therapy due to their potential side effect and propensity for backsliding when discontinued .
Extracorporeal photopheresis has shown bright results in the treatment of generalised deep morphea . Photodynamic therapy using topical 5 - aminolevulinic acid , bosentan ( for refractory ulcerations in panscerotic morphea ) and abatacept have been found helpful for treat deep morphea .
Symptoms Of Morphea
The clinical presentation of morphea or localized scleroderma is divers depending on the subdivision of the disease , localization of the condition and the deepness of involvement . Broadly it can be classified as circumscribe , elongate , generalized , pansclerotic and mixed . The disease outgrowth includes the involvement of the skin in circumscribed subtype localized to one to three lesions , while in generalized subtype spread over a wider expanse of the skin , running subtype involves a linear streak in the skin or involving the deeper tissue paper and sometimes debone too . Pansclerotic subtype involves the skin , fascia , muscles and pearl too . Mixed lesions include one or more subtype occur in an mortal at the same clip . Since , morphea has a potential drop to run a severe course of study , peculiarly in linear and pansclerotic type , it is important to lead up a suitable treatment promptly to avoid unwholesomeness and deformity of the joints causing lasting disability .
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