Localised scleroderma (morphea)

What it is

Generalized morphea is not systemic sclerosis. Morphea is limited to the skin, while systemic sclerosis affects the internal organs, and that single line is what separates the two. The weight of that line is in what systemic sclerosis then carries: its major cause of death is the heart, the lung and the kidney, and its treatment is tailored to the organ system involved - good skin hygiene with low dose prednisone and methotrexate (limited evidence) for the skin, cold avoidance and vasodilators for Raynaud, PPIs then H2 receptor agonists for reflux, broad spectrum antibiotics for small bowel bacterial overgrowth, ACE inhibitors for renal disease, systemic steroids for pericarditis and for myositis, and bosentan, epoprostenol or sildenafil for pulmonary hypertension. Morphea, being limited to the skin, carries none of that organ list.