Absence of both Raynaud's phenomenon and nailfold capillary abnormalities helps to distinguish generalized morphea from systemic sclerosis

When faced with a patient presenting with generalised skin inflammation and sclerosis the first question the treating physician must attempt to answer is: Does this skin disorder represent diffuse cutaneous systemic sclerosis, dcSSc or generalised morphea? The importance of correctly labelling the disease early lies in the fact that dcSSc is by far the more malignant condition with its internal organ involvement. We present three cases who presented in such a manner and suggest that the absence of a history of Raynaud's phenomenon and the absence of abnormalities on nailfold capillary microscopy are reliable features to exclude the diagnosis of dcSSc.