Skin mapping for the classification of generalized morphea.

Area of Science:

• Dermatology
• Medical Research
• Clinical Studies

Background:

• Generalized morphea presents with varied clinical features, hindering effective clinical management and research.
• Objective subtyping is needed to improve the clinical and investigative utility of generalized morphea classification.

Purpose of the Study:

• To objectively subtype generalized morphea using computerized lesion mapping.
• To identify distinct clinical and demographic features associated with identified subtypes.

Main Methods:

• A two-part cross-sectional study involving 123 patients with generalized morphea.
• Computerized lesion mapping was used to identify distribution patterns in a discovery cohort.
• Clinical and demographic data were compared between identified subsets and validated in a separate cohort.

Main Results:

• Two predominant lesion distribution patterns were identified: isomorphic and symmetric.
• The isomorphic subset was associated with older age, female sex, and lichen sclerosus.
• The symmetric subset showed more frequent involvement of deeper skin layers (dermis, subcutaneous fat, fascia).

Conclusions:

• Symmetric and isomorphic subtypes of generalized morphea exhibit distinct demographic and clinical characteristics.
• These findings support the potential for revising the current classification of generalized morphea.
• Objective subtyping may enhance clinical understanding and research efforts.