Shandong Provincial Institute of Dermatology and Venereology and Provincial Hospital for Skin Diseases, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, China.
Skin Res Technol. 2023 Mar;29(3):e13300. doi: 10.1111/srt.13300.
The treatment and curative effect evaluation of localized scleroderma (LS) still perplexes many clinical workers.
To investigate the efficiacy of methotrexate in the treatment of LS by the evaluation of ultrasonography.
A prospective study enrolled 10 patients treated with MTX for at least 6 months was conducted. Treatment outcome was evaluated by a clinical score and 15-MHz ultrasonography. Safety assessment included the monitoring of adverse drug reactions and clinical laboratory examinations.
Eight of the 10 patients achieved clinical remission only with MTX. One patient was relieved after MTX combined with corticosteroids, while another one does not improve after the treatment of mycophenolate mofetil and corticosteroids. The effective rate of MTX is 80%. Nine patients were significantly improved with a decrease of the Localized Scleroderma Cutaneous Assessment Tool (the mean score of the LoSCAT cutaneous activity dropped from 5.2 to 1.0, p < 0.001, the mean score of the LS cutaneous damage dropped from 4.3 to 2.3, p = 0.002). The average difference of thickness between skin lesions and normal skin evaluated by ultrasonography decreased from 0.13 cm to 0.04 cm (p = 0.009) in eight patients. No serious adverse reactions occurred.
Methotrexate is a safe and effective treatment for patients with LS. Ultrasonography can be considered as an efficient assessment tool for evaluation LS.
局限性硬皮病（LS）的治疗和疗效评估仍困扰着许多临床工作者。
通过超声评估来研究甲氨蝶呤（MTX）治疗 LS 的疗效。
进行了一项前瞻性研究，共纳入 10 例至少接受 MTX 治疗 6 个月的患者。通过临床评分和 15MHz 超声评估治疗效果。安全性评估包括不良药物反应监测和临床实验室检查。
10 例患者中有 8 例仅用 MTX 即达到临床缓解。1 例患者在 MTX 联合皮质类固醇治疗后缓解，另 1 例患者在用吗替麦考酚酯和皮质类固醇治疗后无改善。MTX 的有效率为 80%。9 例患者明显改善，局部硬皮病皮肤评估工具（LoSCAT 皮肤活动评分从 5.2 降至 1.0，p<0.001，LS 皮肤损伤评分从 4.3 降至 2.3，p=0.002）评分降低。8 例患者超声评估的皮肤病变与正常皮肤之间的厚度平均差值从 0.13cm 降至 0.04cm（p=0.009）。未发生严重不良反应。
甲氨蝶呤是治疗 LS 患者的安全有效药物。超声检查可作为评估 LS 的有效工具。
