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Morphoea — SCE Dermatology MCQ

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ModerateConnective Tissue & VasculitisMorphoeaSCE Dermatology

A 38-year-old woman is diagnosed with morphoea. Her dermatologist explains the different clinical subtypes. Which subtype has the highest risk of musculoskeletal complications including limb length discrepancy?

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Correct answer: E — Linear morphoea (en coup de sabre or limb variant)

Linear morphoea has the highest risk of musculoskeletal complications because the sclerosis extends through dermis into subcutaneous tissue, fascia, and potentially muscle and bone, causing growth restriction in children. Limb linear morphoea can cause limb length discrepancy, joint contractures, and muscle atrophy. En coup de sabre (forehead/scalp variant) can cause facial hemiatrophy and rarely CNS involvement (seizures, neurological deficits). Linear morphoea in children requires systemic treatment (Methotrexate + corticosteroids) to prevent irreversible growth impairment. Plaque morphoea is usually limited to the skin and rarely causes deep complications.

Reference: BAD 2018 Morphoea Guidelines; EULAR/PRES