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Localized scleroderma and related comorbidities: a single-centre cohort study.

Saara Kortelainen1,2, Niina Hieta3, Tiia Rissanen4

  • 1Centre for Rheumatology and Clinical Immunology, Division of Medicine, Turku University Hospital, Turku, Finland.

The British Journal of Dermatology
|October 27, 2025
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Summary

Localized scleroderma (morphea) affects skin and tissue, more common in females. This study in Finland found high rates of generalized subtype and autoimmune thyroid disease, with methotrexate and phototherapy being effective treatments.

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Area of Science:

  • Dermatology
  • Autoimmune Diseases
  • Rheumatology

Background:

  • Localized scleroderma, or morphea, is a rare autoimmune condition impacting skin and subcutaneous tissues.
  • It disproportionately affects females, with incidence peaks in childhood and middle age.
  • While other autoimmune diseases are common, systemic sclerosis is a rare co-occurrence.

Purpose of the Study:

  • To investigate the clinical characteristics, co-occurring conditions, and treatment outcomes for localized scleroderma patients in Southwest Finland.
  • To analyze demographic data, comorbidities, and treatment efficacy.
  • To classify morphea subtypes according to European Dermatology Forum (EDF) criteria.

Main Methods:

  • Retrospective analysis of 155 patients diagnosed with localized scleroderma (ICD-10 L94) between 2005 and 2020.
  • Data collected from Turku University Hospital discharge register, including demographics, comorbidities, and treatments.
  • Classification of diagnoses into five main types and subtypes based on EDF criteria.

Main Results:

  • Limited plaque-type morphea (45.8%) and generalized morphea (36.8%) were the most prevalent subtypes.
  • Concomitant autoimmune diseases occurred in 29.0% of patients, with autoimmune thyroid disease being most frequent (14.8%).
  • Methotrexate (16.1%) and phototherapy (40.6%) were common systemic treatments, showing significant efficacy (64% and 77.8%, respectively). Extracutaneous manifestations were more frequent in pediatric-onset cases.

Conclusions:

  • Morphea patients frequently require systemic immunomodulatory therapy or phototherapy.
  • A notable incidence of the generalized subtype and autoimmune thyroid disease was observed.
  • No increased risk of malignancy was identified in this patient cohort.