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Localized Fibrosing Disorders - Linear Scleroderma, Morphea, and Regional Fibrosis Differential Diagnoses

  • Author: Mariana J Kaplan, MD; Chief Editor: Herbert S Diamond, MD  more...
 
Updated: Apr 16, 2015
 
 

Diagnostic Considerations

Other problems to consider in the differential diagnosis include the following:

  • Acrodermatitis chronica atrophicans
  • Bleomycin exposure
  • Bromocriptine exposure
  • Carcinoid syndrome
  • Panniculitis
  • Ergot exposure
  • Localized lipoatrophies
  • Methysergide exposure
  • Phenylketonuria
  • POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes)
  • Poikiloderma
  • Porphyria cutanea tarda
  • Scleredema
  • Scleromyxedema
  • Vitamin K injection

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Mariana J Kaplan, MD Assistant Professor, Department of Internal Medicine, Division of Rheumatology, University of Michigan Medical School

Mariana J Kaplan, MD is a member of the following medical societies: American Association of Immunologists, American Federation for Medical Research, Central Society for Clinical and Translational Research, Clinical Immunology Society, American College of Rheumatology, American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Lawrence H Brent, MD Associate Professor of Medicine, Jefferson Medical College of Thomas Jefferson University; Chair, Program Director, Department of Medicine, Division of Rheumatology, Albert Einstein Medical Center

Lawrence H Brent, MD is a member of the following medical societies: American Association for the Advancement of Science, American Association of Immunologists, American College of Physicians, American College of Rheumatology

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Janssen<br/>Serve(d) as a speaker or a member of a speakers bureau for: Abbvie; Genentech; Pfizer; Questcor.

Chief Editor

Herbert S Diamond, MD Visiting Professor of Medicine, Division of Rheumatology, State University of New York Downstate Medical Center; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital

Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

Kristine M Lohr, MD, MS Professor, Department of Internal Medicine, Interim Chief, Division of Rheumatology, Director, Rheumatology Training Program, University of Kentucky College of Medicine

Kristine M Lohr, MD, MS is a member of the following medical societies: American College of Physicians, American College of Rheumatology

Disclosure: Nothing to disclose.

References
  1. Todd DJ, Askari A, Ektaish E. PUVA therapy for disabling pansclerotic morphoea of children. Br J Dermatol. 1998 Jan. 138(1):201-2. [Medline].

  2. Mancuso G, Berdondini RM. Localized scleroderma: response to occlusive treatment with tacrolimus ointment. Br J Dermatol. 2005 Jan. 152(1):180-2. [Medline].

  3. Namazi MR. Imiquimod: a potential weapon against morphea and fibromatoses. J Drugs Dermatol. 2004 Jul-Aug. 3(4):362-3. [Medline].

  4. Mizutani H, Yoshida T, Nouchi N, et al. Topical tocoretinate improved hypertrophic scar, skin sclerosis in systemic sclerosis and morphea. J Dermatol. 1999 Jan. 26(1):11-7. [Medline].

  5. Dehen L, Roujeau JC, Cosnes A, et al. Internal involvement in localized scleroderma. Medicine (Baltimore). 1994 Sep. 73(5):241-5. [Medline].

  6. Eguchi T, Harii K, Sugawara Y. Repair of a large "coup de sabre" with soft-tissue expansion and artificial bone graft. Ann Plast Surg. 1999 Feb. 42(2):207-10. [Medline].

  7. Falanga V, Medsger TA Jr, Reichlin M, et al. Linear scleroderma. Clinical spectrum, prognosis, and laboratory abnormalities. Ann Intern Med. 1986 Jun. 104(6):849-57. [Medline].

  8. Ghersetich I, Teofoli P, Benci M, et al. Localized scleroderma. Clin Dermatol. 1994 Apr-Jun. 12(2):237-42. [Medline].

  9. Gilkeson GS, Allen NB. Retroperitoneal fibrosis. A true connective tissue disease. Rheum Dis Clin North Am. 1996 Feb. 22(1):23-38. [Medline].

  10. Jablonska S, Blaszczyk M. Sclerodermalike diseases. Clin Dermatol. 1994 Jul-Sep. 12(3):437-48. [Medline].

  11. Kerscher M, Volkenandt M, Gruss C, et al. Low-dose UVA phototherapy for treatment of localized scleroderma. J Am Acad Dermatol. 1998 Jan. 38(1):21-6. [Medline].

  12. Mathisen DJ, Grillo HC. Clinical manifestation of mediastinal fibrosis and histoplasmosis. Ann Thorac Surg. 1992 Dec. 54(6):1053-7; discussion 1057-8. [Medline].

  13. Peterson LS, Nelson AM, Su WP. Classification of morphea (localized scleroderma). Mayo Clin Proc. 1995 Nov. 70(11):1068-76. [Medline].

  14. Schachter RK. Localized scleroderma. Curr Opin Rheumatol. 1989 Dec. 1(4):505-11. [Medline].

  15. Schumacher HR. Multifocal fibrosclerosis. Cecil Textbook of Medicine. WB Saunders Co; 2000. 1561-62.

  16. Varga J, Kahari VM. Eosinophilia-myalgia syndrome, eosinophilic fasciitis, and related fibrosing disorders. Curr Opin Rheumatol. 1997 Nov. 9(6):562-70. [Medline].

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This photograph shows morphea en plaque on the trunk of a patient. There is a distinctive border separating the plaque from the surrounding normal skin (reproduced with permission of Mayo Clinic Proceedings).
This photograph shows generalized morphea on the trunk of a patient (reproduced with permission from Mayo Clinic Proceedings).
CT scan of the abdomen showing the typical paraaortic mass of retroperitoneal fibrosis.
 
 
 
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