Department of Dermatology, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Department of Dermatology, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
J Am Acad Dermatol. 2021 Jul;85(1):105-113. doi: 10.1016/j.jaad.2020.11.006. Epub 2020 Nov 12.
The clinicopathologic correlations and prognostic risk factors for refractory disease in morphea (localized scleroderma) are poorly described.
To investigate the association between clinical characteristics and histopathologic features of morphea and identify risk factors for refractory disease.
We retrospectively reviewed the clinical and histopathologic features, treatment regimens, and clinical responses for 137 patients with biopsy-proven morphea from January 2008 to May 2019. Multivariate analysis was conducted to identify factors associated with poor treatment response.
We detected associations between the pattern and degree of sclerosis and the anatomic site of the lesion, as well as between severe inflammation and concomitant autoimmune disease. Additionally, both bottom-heavy sclerosis and increased inflammation were associated with functional limitations/clinical symptoms. Based on our multivariate analysis, we found that increased risk of poor treatment response was correlated with tissue eosinophils and basal pigmentation.
This was a single-center retrospective study.
Skin biopsy samples could show specific features of morphea, including eosinophil infiltration and basal pigmentation, which may indicate the need for aggressive treatment and frequent monitoring.
硬斑病（局限性硬皮病）难治性疾病的临床病理相关性和预后危险因素描述不足。
研究硬斑病的临床特征与组织病理学特征之间的关系，并确定难治性疾病的危险因素。
我们回顾性分析了 2008 年 1 月至 2019 年 5 月期间经活检证实的 137 例硬斑病患者的临床和组织病理学特征、治疗方案和临床反应。采用多变量分析确定与治疗反应不良相关的因素。
我们发现硬化的模式和程度与病变的解剖部位之间存在关联，以及严重炎症与伴发自身免疫性疾病之间存在关联。此外，底部沉重的硬化和炎症增加都与功能障碍/临床症状有关。基于我们的多变量分析，我们发现组织嗜酸性粒细胞和基底色素沉着增加与治疗反应不良的风险增加相关。
这是一项单中心回顾性研究。
皮肤活检样本可能显示硬斑病的特定特征，包括嗜酸性粒细胞浸润和基底色素沉着，这可能表明需要积极治疗和频繁监测。
