No abstract

No abstract

Background: Prospective, longitudinal studies examining the features of linear morphea are limited. Objective: To utilize the Morphea in Adults and Children cohort to determine clinical characteristics, impact on life quality, and disease course of linear morphea in a prospective, longitudinal manner. Methods: Characteristics of linear morphea versus other subtypes were compared in a cross-sectional manner. Next, linear morphea participants were examined in depth over a 3-year period. Results: Linear morphea was the most common morphea subtype (50.1%, 291/581) in the cohort. Deep involvement was more common in linear (64.3%, 187/291) than other morphea subtypes. Linear morphea participants with deep involvement were more likely to have a limitation in range of motion (28.6%, 55/192) than those without (11.1%, 11/99, P \ .001). Adult-onset disease occurred in 32.6% (95/291) of those with linear morphea. Frequency of deep involvement was similar between pediatric (66.8%, 131/196) and adult-onset linear morphea (58.9%, 56/95, P = .19). Quality of life and disease activity scores improved over time, while damage stabilized with treatment. Limitations: Results of the study are associative, and the University of Texas Southwestern Medical Center is a tertiary referral center. Conclusion: A substantial number of linear morphea patients have adult-onset disease. In all age groups, linear morphea with deep involvement was associated with functional limitations.

IMPORTANCEFirst-line systemic therapy for morphea includes methotrexate with or without systemic corticosteroids. When this regimen is ineffective, not tolerated, or contraindicated, a trial of mycophenolate mofetil (MMF) or mycophenolic acid (MPA)-referred to herein as mycophenolate-is recommended; however, evidence to support this recommendation remains weak.OBJECTIVE To evaluate the effectiveness and tolerability of mycophenolate for the treatment of morphea.

Vitiligo is a chronic depigmenting disorder of multifactorial etiology affecting 0.5% to 1% of the population. The white macules characteristic of vitiligo have been shown to have a profound impact on quality of life (QOL) in affected individuals. 1,2 The goal of this cross-sectional study was to determine the location(s) of vitiligo lesions that has the greatest effect on QOL.Methods | All patients enrolled in the Dallas Vitiligo Registry (DVR) at the University of Texas Southwestern (UTSW) Medical Center from April 2013 to August 2015 were reviewed. The DVR was approved by the UTSW Medical Center institutional review board and all patients gave informed consent. They were not compensated for their participation. A total of 184 patients were examined. It was determined that a total sample size of 184 would provide 80% power with a type 1 error of .05. The location of each affected area of skin was documented and the total body surface area affected as well as the vitiligo area severity index was calculated. Each participant also completed the VitiQoL, a vitiligo-specific QOL instrument. 3 The VitiQoL contains 16 questions divided into 3 domains: participation limitation, stigma, and behavior. Questions in the participation limitation domain include those asking about the patient's ability to perform daily activities and social and leisure activities. Stigma includes questions about embar-