Morphea in Middle Anatolia, Turkey: a 5-year single-center experience

Abstract

IntroductionMorphea, also referred to as localized scleroderma, is a rare fibrosing skin disorder of undetermined cause.AimWe report our single-center experience with morphea.Material and methodsThe study included 53 patients who were diagnosed with morphea by histopathology in our department between 2010 and 2015. Study data were collected retrospectively from the records of morphea patients.ResultsThe study included 53 patients (38 women, 15 men), and median age at onset was 39.0 (range: 8–85) years. Thirty (56.6%) patients had circumscribed morphea, 15 (28.3%) had generalized morphea, and 7 (13.2%) had linear morphea. One patient had mixed variant morphea (generalized, pansclerotic and linear morphea). ANA positivity was detected in 12 (22.6%) patients, but analysis for an association between the presence of ANA and morphea types, patients’ characteristics did not reveal any significant associations. We did not observe any extracutaneous manifestations in patients during follow-up period. There were 2 of 53 patients who had concomitant autoimmune disorder including vitiligo and spondyloarthritis. Thirty (56.6%) patients received only topical treatment. The patients with clinical improvement who were treated with systemic therapy received methotrexate (26.4%), colchicine (9.4%), mycophenolate mofetil (5.7%) and prednisolone (1.9%).ConclusionsOur results related to the demographic data of the patients and morphea types were consistent with the literature. On the other hand we observed that methotrexate was mostly used as an effective treatment option for generalized morphea.

Lokalize Skleroderma Tanılı Çocuk Hastaların Klinik ve Demografik Özellikleri

“…(18) determined it as 3.5 and Leitenberger (19) as 3.7. Although the ratio of girls/boys was found to be between 2.4 and 1.2 in other studies performed in our country, we found it to be 3.9 in our 39 cases, which is comparable with the most available literature (11,12).…”

“…The rate of affected females is 2-4 times higher than affected males in morphea (2,4,5). The most comprehensive one of the multi-centered studies up to this date belongs to Zulian Although the ratio of girls/boys was found to be between 2.4 and 1.2 in other studies performed in our country, we found it to be 3.9 in our 39 cases, which is comparable with the most available literature (11,12).…”

“…Colchicine is a preferred drug in our country, as well as in Korea (35). Some researchers in our country have reported the effectiveness of colchicine treatment in their patients (12,13). In this study, colchicine treatment was given to 10 patients (25.6%).…”

“…20 % of morphea patients consist of children, and it is 10 times more common than systemic sclerosis (4,7,9,10). Although several studies are available worldwide on the epidemiological, clinical and laboratory data of patients with pediatric morphea, there is a shortage of these data in our country (11)(12)(13). The aim of the present study was to investigate the demographic, clinical, laboratory characteristics and treatment modalities of pediatric patients with morphea, also to compare our findings with the available literature.…”

On which evidence can we rely when prescribing off-label methotrexate in dermatological practice? – a systematic review with GRADE approach

“…We included 20 studiesone RCT, four cohort studies, and 15 case series studiescomprising a total of 644 patients; 14 of these studies involved children (30,35,41,51,56,61,67,69,(129)(130)(131)(132)(133)(134). One RCT on juvenile morphea was found (Zulian et al) (51) that enrolled 70 patients (46 in the MTX group, 24 in the placebo group).…”