Diagnosis

In its advanced stage, morphoea is so characterised that its diagnosis is readily made. Sometimes, however, it is so very like scleroderma that it is difficult to differentiate between them.
In scleroderma the patches are usually symmetrically distributed, and the affected skin is hide-bound, or cannot be lifted up into a fold by the fingers, and feels hard. In morpihoea the patches are symmetrically distributed, and the affected skin feels soft or firm.

In scleroderma the patches are not circumscribed, but show a tendency to spread over a large surface, and at their border merge indistinctly and gradually into the surrounding skin. In morphoea the patches are often distinctly circumscribed, and confined to a limited area; and in their early stage are surrounded with a tinted border of pinkish or lilac hue, or the surrounding healthy skin is more or less pigmented.



When the pigmentless spots in vitiligo resemble the whitish spots of morphoea, it is only to be remembered that the former is due simply to the absence of pigment, while the latter is caused by an abnormal state of structure, and of vascular supply.

Patches of morphoea sometimes present appearances very similar to those of anaesthetic leprosy. The objective and subjective symptoms in the progress of these diseases are so different as to render the diagnosis between them certain.