I plan to specialise in Morphea. Morphea or localised scleroderma, is a rare but devastating relapsing-remitting skin disorder. It first appears as subtle skin inflammation followed but deep scarring of the skin and underlying tissues. It may extend deeper affecting the muscle and underlying bone. Limb involvement can result in contractures of the joint affecting movement and facial involvement can cause extreme disfigurement with both neurological and ocular complications. Morphea is difficult to diagnose and extremely difficult to monitor. Diagnostic delays are common resulting in irreversible scarring. Morphea is a clinical diagnosis; there is no specific blood test and biopsies do not correlate with disease activity. Biopsies also risk further scarring, worsening of the underlying condition and access may be limited in cosmetically sensitive sites. The gold standard treatment of active disease is to suppress the immune system with medications. Given the relapsing-remitting nature of the disease and possible serious consequences, treatment with immunosuppression is often continued for years. The inability to accurately track disease activity makes management decisions really challenging. It is difficult to know who to treat, when to treat, when to stop treating, and whether or not a treatment regimen is working. My research aims to identify non-invasive markers of disease activity in morphea which could revolutionise our approach to the management of the disease. Morphea is a rare disease, with an incidence between 4 to 27 new cases per million people. There is currently no morphea specialist in Ireland. During my time in the United States, I hope to conduct research with Professor Heidi Jacobe, a world-renowned expert in Morphea based in UT Southwestern Medical centre, which will be integral to the success of my research.
