571 Morphea in patients of color: A cross sectional study of the morphea in adults and children (MAC) cohort

Abstract

Morphea is an autoimmune sclerosing skin condition. While clinical manifestations of morphea are well described in Caucasians, characteristics of morphea in patients of color have been poorly studied. Thus, the aim of this study was to determine the demographic and clinical characteristics of morphea in patients of color. This was an analysis of patients in the Morphea in Adults and Children Registry from 2007 to 2020. Kruskal-Wallis, Chi-square and Fischer’s exact tests were performed to investigate differences between racial groups. Post-hoc analysis was performed with Dunn’s test to directly compare individual racial groups. Of 772 patients in the registry, the majority had linear morphea (47%), and were white (73%). Overall, patients of color comprised 27% of the entire cohort, with 5% Black, 4% Asian, 14% Hispanic, and 4% Other. Age of morphea onset showed significant differences between racial groups (p=0.004). Black patients were more likely to have a later disease onset compared to non-Black patients and were less likely to have linear morphea (p=0.005). Asian and Hispanic patients were found to have similar subtype distribution to white patients. Years to diagnosis from disease onset also varied between racial groups (p=0.0058). Black and Hispanic morphea patients had a delayed diagnosis compared to White morphea patients [2.85 and 2.73 years in Black (p=0.015) and Hispanic (p=0.011) patients respectively vs 2.08 years in white patients]. Hispanic patients had higher disease damage by PGA-D, when compared to compared to White patients (Median: 30, IQR: 20-50 v. Median: 20, IQR: 10-40, p=<0.001). Our study demonstrates that morphea is infrequent in patients with skin of color, but still occurs in a substantial number of patients. We underscore the need for dermatologists to carefully consider distinct disease characteristics in patients of color, especially given the delay in diagnosis time experienced by Black and Hispanic patients compared to White patients.