[Diagnostic and therapeutic problems of scleroderma]

Scleroderma is the autoimmunologic disease with induration and fibrosis of the skin, subcutaneous tissue; sometimes refers to muscles, bones and other internal organs. Pathogenesis of morphea is still unknown. There are two main types of scleroderma: the first type is related only to the skin (localized scleroderma--morphea), while the second is connected with fibrosis and induration of the skin, lungs, heart and other organs (systemic sclerosis). There are various clinical forms of scleroderma circumscripta: linear scleroderma (the most frequent in children), morphea en plaque, generalized morphea, nodular and keloidea like, morphea guttata, scleroderma circumscripta with blisters on the surface-bullous morphea. Morphea profunda is the most severe type of scleroderma localized on the skin. Although the diagnosis of morphea is not so difficult, the treatment is problematic and not very effective. It is very important to initiate the proper treatment as soon as possible. There are three main ways of morphea treatment: medication (receiving local or per os), physical methods (for example phototherapy) and balneotherapy or climatic treatment.