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Bowen's disease

This is a superficial, scaly plaque (SCC in situ), not a deep, hardened, sclerotic plaque like morphea.

Carcinoma en cuirasse

This is metastatic breast cancer causing a diffuse, armor-like hardening of the skin, a malignant and infiltrative process unlike morphea.

Chronic graft versus host disease

Sclerotic GVHD can be identical to morphea but is distinguished by its occurrence in the specific setting of a prior allogeneic transplant.

Dermatofibrosarcoma protruberans

This is a firm, indurated tumor that is fixed to deeper structures, whereas a morphea plaque is a sclerotic patch of skin itself.

Extragenital lichen sclerosus

Lichen sclerosus is distinguished by its porcelain-white color and atrophic, "crinkled" texture, whereas morphea is characterized by induration and sclerosis.

Injection site sclerosis

This is distinguished by a clear history of injections (e.g., insulin) at the site of the hardened plaque.

Lipodermatosclerosis

This is a sclerosis of the lower legs due to chronic venous insufficiency, distinguished by its "inverted champagne bottle" shape and other signs of stasis.

Morpheaform sarcoidosis

This is a rare variant of sarcoidosis that presents with indurated plaques, but a biopsy will show non-caseating granulomas, not the homogenized collagen of morphea.

Nephrogenic systemic sclerosis

This is a sclerosing condition seen in patients with renal failure exposed to gadolinium contrast, a specific clinical context.

Porphyria cutanea tarda

The sclerodermoid plaques in PCT are associated with other signs like skin fragility, vesicles, and hypertrichosis on the hands.

Radiation induced morphea

This is distinguished by the hardened plaque appearing in a field of prior radiation therapy.

Sclerosing congenital melanocytic naevus

This is a congenital mole that has undergone fibrosis, a different origin than primary morphea.

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