Morphea disease activity during pregnancy: A case series

Area of Science:

• Dermatology
• Rheumatology
• Obstetrics & Gynecology

Background:

• Morphea, a rare autoimmune condition causing skin hardening, has limited documented information regarding its course during pregnancy.
• Understanding morphea's impact on pregnancy is crucial for effective patient management and counseling.

Purpose of the Study:

• To describe the clinical presentation of morphea in pregnant women.
• To evaluate pregnancy outcomes in patients with morphea.
• To document the medical management of morphea during pregnancy.

Main Methods:

• A case series was conducted using data from the Morphea in Adults and Children (MAC) cohort.
• Included were female patients aged 18-49 years who were pregnant during study visits and had at least 6 months of follow-up.
• Data collected included demographics, morphea characteristics, pregnancy outcomes, and medication history, with disease activity and damage assessed using the Localized Scleroderma Cutaneous Assessment Tool.

Main Results:

• Ten pregnant patients with morphea were analyzed; five had pediatric-onset and five had adult-onset disease.
• Most patients (70%) maintained stable morphea, with no increase in disease activity or damage scores.
• Three patients (30%) experienced morphea reactivation during pregnancy; only one required immunosuppressive therapy. Seven deliveries were by cesarean section, with one adverse fetal outcome reported.

Conclusions:

• Most women with morphea experience stable disease during pregnancy.
• Adverse pregnancy outcomes directly attributed to morphea were not observed in this series.
• Further research is needed to fully understand morphea's impact on pregnancy, but current findings suggest a generally favorable outlook.