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Histopathologic Spectrum of Morphea. Am J Dermatopathol 2021 Jan 01;43(1):1-8

Date

12/19/2020

Pubmed ID

33337624

DOI

10.1097/DAD.0000000000001662

Scopus ID

2-s2.0-85098829381 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

Morphea is an autoimmune skin disease with protean clinical manifestations. Histologic features are similarly variable, and skin biopsies may be nondiagnostic. A single-institution retrospective cohort study was conducted. Morphea patients who had a biopsy in 2005-2015 were included, and a histopathological review was conducted by 2 pathologists. There were 51 biopsy specimens from 40 subjects. The most common histologic features were dermal sclerosis (90%), dermal thickening (78%), collagen homogenization (86%), a superficial and deep infiltrate (76%), a moderate-abundant inflammatory infiltrate (73%), and periadnexal fat loss/decreased skin appendages (71%). Twenty-four specimens were not diagnostic of morphea. In these specimens, the main clues to diagnosis included the presence of dermal sclerosis (79%), subtle collagen homogenization (75%), dermal thickening (58%), moderate-to-abundant plasma cells (50%), and perineural inflammation (50%). There were no statistically significant differences between active and inactive lesions, nor untreated and treated lesions. The histopathologic features of morphea are variable and a high proportion of biopsies are not diagnostic. Clinicians and pathologists should have a high degree of suspicion to correctly make the diagnosis of morphea.

Author List

Chiu YE, Abban CY, Konicke K, Segura A, Sokumbi O

Author

Yvonne E. Chiu MD Vice Chair, Professor in the Dermatology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Cohort Studies
Female
Humans
Male
Middle Aged
Retrospective Studies
Scleroderma, Localized
Young Adult