A retrospective study on clinical subtypes and management of morphea in 10 Italian Dermatological Units

Annaluci Virdi, Annalisa Patrizi, Stefano Cambiaghi, Andrea Diociaiuti, May El Hachem, Donatella Schena, Andrea Bassi, Domenico Bonamonte, Valeria Brazzelli, Anna Belloni Fortina, Patrizia Pepe, Vito Di Lernia, Iria Neri

Research output: Contribution to journalReview articlepeer-review

Abstract

BACKGROUND: There are still few dermatological studies on morphea. We evaluated the epidemiological and clinical features and management of pediatric morphea, reporting dermatologists experience. METHODS: A multicenter retrospective observational study was carried out on the epidemiological and clinical features and management of the disease between 01/01/2009 and 01/10/2014 in 10 Italian Dermatological Units. RESULT S: We collected the data of 69 children affected by: circumscribed morphea (39.1%); linear morphea of trunk and limbs (14.5%); en coupe de sabre morphea (ECDS) (14.5%); progressive facial hemiatrophy (8.7%); generalized form (18.8%); mixed morphea (4.4%). The mean age at onset was 6.86±3.21 years, mainly between 2 and 8 years, but is statistically significantly lower for ECDS (4.5±3.03). Localizations were: head/neck (30.4%), limbs (26.1%), trunk (14.5%), 2 or more sites (29%), most often the trunk plus limbs. Extracutaneous manifestations were observed in 26.1% patients. 10 patients presented a second autoimmune disorder. Treatments were topical in 26.1% cases and systemic (alone or associated with topical treatments) in 68.1%. CONCLUSIONS: There was a lack of uniformity in the management of patients and an increasing awareness of dermatologists on the use of systemic therapies, in particular of methotrexate, which is no longer exclusive to rheumatologists. Methotrexate causes stabilization and improvement of the clinical signs, but topical creams are still considered adjuvant or maintenance therapies during/after the use of systemic drugs.

Original languageEnglish
Pages (from-to)446-454
Number of pages9
JournalItalian Journal of Dermatology and Venereology
Volume70
Issue number4
DOIs
Publication statusPublished - Aug 2021

Keywords

  • Child
  • Dermatologists
  • Localized
  • Scleroderma

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

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