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Suggest Medication For Morphea
Question: Recently diagnosed with Morphea. Unable to tolerate Methotrexate due to severe side effects. What can I do now,aside from more serious meds? What is my prognosis.
Brief Answer:
Steroids(topical & oral); topical tacrolimus; oral hydroxychloroquin; UVA1
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query and I have noted down your concern.
The prognosis of morphea is generally good as the disease process is limited to the skin and presenrs as either a single or a few patches of sclerosis, and nothing more than topical potent steroid creams is usually prescribed for a few patches of morphea as it is a self limiting disease.
Out of all types of morphea only linear morphea and its varients like fronto-parietal morphea Or parry romberg's syndrome or pansclerotic morphea are usually associated with deeper tissue involvement like subcutaneous fat, fascia, muscle and bones etc and cause considerable disfigurement and deformity in those affected.
I would like to know what is the involvement with morphea like, in your case? the distribution of morphea?
Apart from topical steroids other common treatment modalities for morphea are topical tacrolimus and systemic therapies like oral steroids, UVA1 Phototherapy, oral hydoxychloroquin etc.
Regards
Steroids(topical & oral); topical tacrolimus; oral hydroxychloroquin; UVA1
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query and I have noted down your concern.
The prognosis of morphea is generally good as the disease process is limited to the skin and presenrs as either a single or a few patches of sclerosis, and nothing more than topical potent steroid creams is usually prescribed for a few patches of morphea as it is a self limiting disease.
Out of all types of morphea only linear morphea and its varients like fronto-parietal morphea Or parry romberg's syndrome or pansclerotic morphea are usually associated with deeper tissue involvement like subcutaneous fat, fascia, muscle and bones etc and cause considerable disfigurement and deformity in those affected.
I would like to know what is the involvement with morphea like, in your case? the distribution of morphea?
Apart from topical steroids other common treatment modalities for morphea are topical tacrolimus and systemic therapies like oral steroids, UVA1 Phototherapy, oral hydoxychloroquin etc.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have been on prednisone, which I had severe diarrhea, then Methotrexate, which caused bruising, increased depression and mood swings, severe abdominal cramps. Have spreading of the disease....legs, abdomen, breasts.
Prednisone, Methotrexate and photo therapy unsuccessful. Side effects from the meds caused me to stop. Morphea is now across and under breasts, both legs which cause some discomfort on shin bones occasionally. Also across abdomen. Will this spread to face. What other treatments can I consider?
Prednisone, Methotrexate and photo therapy unsuccessful. Side effects from the meds caused me to stop. Morphea is now across and under breasts, both legs which cause some discomfort on shin bones occasionally. Also across abdomen. Will this spread to face. What other treatments can I consider?
Brief Answer:
Pulse oral steroids; hydroxychloroquin; mycophenolate; penicillamine
Detailed Answer:
Hi.
Oral steroids are the ones which are most effective in arresting progression of morphea. Instead of daily dose it might be beneficial if you are started on a pulse dosing of oral steroids i.e oral steroids on just 2 consecutive days of a week e.g saturday and sunday. This would reduce side effects as well as serve the purpose.
Morphea can involve face and it is not possible for me to predict with certainty whether it will involve face in your case or not. Even though morphea is self limiting however it is not possible to predict when would the disease activity die down on its own therefore if morphea is progressing in your case, the goal should be to arrest its further progression with appropriate treatment.
Other oral treatments that can be considered are hydrochloroquin, cyclosporine, mycophenolate mofetil and d-penicillamine.
Regards
Pulse oral steroids; hydroxychloroquin; mycophenolate; penicillamine
Detailed Answer:
Hi.
Oral steroids are the ones which are most effective in arresting progression of morphea. Instead of daily dose it might be beneficial if you are started on a pulse dosing of oral steroids i.e oral steroids on just 2 consecutive days of a week e.g saturday and sunday. This would reduce side effects as well as serve the purpose.
Morphea can involve face and it is not possible for me to predict with certainty whether it will involve face in your case or not. Even though morphea is self limiting however it is not possible to predict when would the disease activity die down on its own therefore if morphea is progressing in your case, the goal should be to arrest its further progression with appropriate treatment.
Other oral treatments that can be considered are hydrochloroquin, cyclosporine, mycophenolate mofetil and d-penicillamine.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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