Children and adolescents
Localized scleroderma (morphea)
Patches or bands of skin thickening. Linear lesions on a limb or the face can affect growth, eyes or the brain.
What to look for
- Circumscribed plaques or linear bands of induration and color change
- Linear limb lesions can cause limb-length discrepancy or contracture
- Facial lesions (en coup de sabre, Parry-Romberg) can involve the eye or CNS
What to do
- Refer early for linear, facial, deep, generalized or rapidly progressive disease. These are urgent.
- Methotrexate with initial glucocorticoids is the usual systemic treatment for active disease.
- Facial disease needs an eye exam and sometimes brain MRI.
About this urgency level
Specialist evaluation helps, but these are usually less time-sensitive than new inflammatory arthritis or connective tissue disease.
Timeframes are typical targets. Local pathways, capacity and clinical judgment come first.