Division of Pediatric Dermatology, Department of Dermatology, University of Minnesota, Minneapolis, Minnesota.
Division of Pediatric Rheumatology, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
J Am Acad Dermatol. 2018 Jul;79(1):47-51.e2. doi: 10.1016/j.jaad.2018.03.005. Epub 2018 Mar 10.
Morphea or localized scleroderma is an inflammatory disorder resulting in fibrosis of the skin and subcutaneous tissues. Joint contractures, arthralgias, and functional compromise are recognized associations of pediatric morphea. The co-existence of inflammatory arthritis and morphea is not well-described in the literature.
To investigate the relationship between pediatric morphea and inflammatory arthritis with regards to cutaneous, musculoskeletal, and laboratory findings and treatment regimens.
A systematic retrospective chart review of 53 patients with pediatric morphea was performed and analyzed for morphea subtypes, arthritic joint involvement, serum autoantibodies, and therapeutic interventions.
Eleven out of 53 patients had polyarthritis that involved joints unrelated to the site of the cutaneous morphea. These patients were mostly girls with either the linear or generalized subtypes of morphea. Serum levels of antinuclear antibodies were more significantly elevated in patients with arthritis. All children were treated with methotrexate in addition to other systemic or topical immunosuppressive agents.
This was a small, single-center retrospective study.
Pediatric morphea co-existed with inflammatory arthritis in 11 of 53 children. Further understanding and appreciation of this relationship may direct more intensive therapy and musculoskeletal screening.
硬斑病或局限性硬皮病是一种炎症性疾病，导致皮肤和皮下组织纤维化。关节挛缩、关节痛和功能障碍是儿童硬斑病的公认并发症。炎症性关节炎与硬斑病同时存在的情况在文献中描述得并不充分。
研究儿童硬斑病和炎症性关节炎之间在皮肤、肌肉骨骼和实验室检查以及治疗方案方面的关系。
对 53 例儿童硬斑病患者进行了系统的回顾性图表审查，并对硬斑病亚型、关节炎关节受累、血清自身抗体和治疗干预措施进行了分析。
53 例患者中有 11 例出现了与皮肤硬斑病部位无关的多关节炎。这些患者大多为女孩，患有线状或广泛型硬斑病。关节炎患者的抗核抗体水平显著升高。所有患儿除其他全身性或局部性免疫抑制剂外，均接受甲氨蝶呤治疗。
这是一项小型的、单中心的回顾性研究。
53 例儿童中有 11 例硬斑病与炎症性关节炎并存。进一步了解和认识这种关系可能会指导更强化的治疗和肌肉骨骼筛查。
