LOCALIZED SCLERODERMA

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    LOCALIZED SCLERODERMA

     

    DEFINITION:

    A multiorgan rheumatologic disease characterized by fibrosis limited to the skin, subcutaneous tissue, and muscle and rarely involving the visera.

    EPIDEMIOLOGY:

    • incidence: more common that Progressive Systemic Sclerosis (PSS) (PSS)
    • age of onset:
      • more common in childhood than PSS
    • risk factors:
      • F > M (1.6:1)

    PATHOGENESIS:

    1. Etiology

    • see PSS

    2. Types (2)

    • Morphea
    • Linear

    CLINICAL FEATURES:

    1. Constitutional symtoms

    • ?

    2. Skin Manifestations

    1. Morphea

    • one or more oval or round circumscribed indurations that become hard and white
    • found in skin anywhere on trunk or extremities
    • characteristic violet border found early in disease

    2. Linear

    • one or more linear streaks on scalp, face, extremities
    • found in skin but involve underlying subcutaneous tissue, tendons, muscle, and bone -> contractions & deformities
    • scleroderma en coup de sabre - lesions of face or scalp
    • associated with significant local growth arrest -> atrophy of the skin, subcutaneous tissue, and bone

    3. Visceral Manifestations

    • occasionally develops late suggesting an evolution of the local to systemic forms of scleroderma
    • occasionally develop other connective tissue diseases: SLE, MCTD

    INVESTIGATIONS:

    1. Serum

    • ANA present in 37-67%, pattern speckled, homogeneous, or nuclear
    • +/- anti-DNA antibodies
    • increased Ig
    • RF seronegative

    MANAGEMENT:

    1. Supportive

    • Morphea - regresses spontaneously thus no treatment needed
    • Linear - may cause significant functional and cosmetic problems

    2. Drugs

    • Morphea - penicillamine is drug of choice
      • dilantin

     

     

    Pediatric Database - LOCALIZED SCLERODERMA

    Pediatric Organization - Pedbase [at] Gmail.com