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Conflict of interest: none declared.

Morphoea is a connective‐tissue disorder that affects the skin and subcutaneous tissues, with typical lesions consisting of sclerotic plaques. Numerous treatments have been used, including topical and intralesional corticosteroids, topical calcipotriol, phototherapy, ciclosporin and methotrexate for more severe disease,1 with variable success. Topical photodynamic therapy (PDT) using 5‐aminolaevulinic acid (ALA) is primarily used for the treatment of nonmelanoma skin cancers, but has been trialled in a variety of inflammatory skin conditions. An uncontrolled trial of only five patients showed a beneficial effect of application of 3% 5‐ALA gel followed by irradiation with an incoherent lamp once or twice weekly for 3–6 months2 in patients with localized scleroderma. In all patients, therapy was assessed as highly effective for sclerotic plaques, as measured by durometer score and skin score.3

To further investigate this form of therapy, a single‐blind, prospective, comparative single‐centre pilot study with intraindividual control was performed. Approval was obtained from the Leeds (West) ethics committee.

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