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Clinical characteristics and histopathologic changes of morphea: A single-center, retrospective study of 137 patients
Jemin Kim1, Kyung Bae Chung1, Young In Lee1
1Department of Dermatology, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Background:
The clinicopathologic correlations and prognostic risk factors for refractory disease in morphea (localized scleroderma) are poorly described.
Objective:
To investigate the association between clinical characteristics and histopathologic features of morphea and identify risk factors for refractory disease.
Methods:
We retrospectively reviewed the clinical and histopathologic features, treatment regimens, and clinical responses for 137 patients with biopsy-proven morphea from January 2008 to May 2019. Multivariate analysis was conducted to identify factors associated with poor treatment response.
Results:
We detected associations between the pattern and degree of sclerosis and the anatomic site of the lesion, as well as between severe inflammation and concomitant autoimmune disease. Additionally, both bottom-heavy sclerosis and increased inflammation were associated with functional limitations/clinical symptoms. Based on our multivariate analysis, we found that increased risk of poor treatment response was correlated with tissue eosinophils and basal pigmentation.
Limitations:
This was a single-center retrospective study.
Conclusion:
Skin biopsy samples could show specific features of morphea, including eosinophil infiltration and basal pigmentation, which may indicate the need for aggressive treatment and frequent monitoring.
