Development of an Activity Index for Localized Scleroderma (Morphea) PDF Print E-mail
Wednesday, 21 September 2011 00:39
E. Lanciano, A. CHIALà, E. Praino, V. Grattagliano, M. Covelli, F. Iannone, G. Lapadula Reumatologia Universitaria, Policlinico, Bari, Italy
Ann Rheum Dis 2011;70(Suppl3):481

Background: Morphea is a skin disorder characterized by fibrosis. It affects more commonly females than males (ratio 3:1) with an year incidence of 27/million. Recently, some studies have shown that methotrexate and UVA-1 phototherapy may be effective in the treatment of Morphea. However, an index to monitor the disease activity and to evaluate the response to the therapy is not available. Aim of this study was to construct an index for Morphea by considering some parameters of objective evaluation of the skin lesions.

Methods: We enrolled 8 patients with morphea and for each of them the degree of infiltration of the lesions, the color of the margins and the size in cm2 were evaluated. In case of multiple lesions only the largest was considered. To each of these parameters a score from 0 (remission) to 3 (the highest activity) was assigned. The color of the margins indistinguishable from normal surrounding skin was considered as 0, as 1when the colour was dull beige, as 2 when it was pinkish, and as 3 when the colour was clearly red. With regard to the degree of infiltration the modified Rodnan Skin Score was used (0 for normal skin, 1 in case of mild infiltration, 2 in case of moderate infiltration and 3 for severe infiltration). As far as the size of lesions concerns, score 1 was assigned to lesions up to 50 cm2, score 2 to those between 50 and 100 cm2, score 3 to those larger than 100 cm2. The index of disease activity was indicated as high if between 6 and 9, moderate if between 4 and 6, low if between 1 and 3. While a complete resolution of lesions was considered as 0.The patients received methotrexate at a dose of 10-15 mg per week and methylprednisolone at a dose of 4 mg daily for 6 months. Clinical evaluation was performed at 3, 6, and 12months

Results: In all cases we had a good clinical response after 3 months of treatment,with almost complete resolution after 6 months. At baseline we evaluated an average index of 8, after 3 months it was equal to 4.25, at 6 months the index was estimated at 3, and after further 6 months free of therapy the index was unchanged.

Conclusions: This pilot study provided evidence that a combined therapy of methotrexate and low dose steroids may be effective to treat morphea. Further studies on larger cohort of patients are needed to validate this activity index.

For a link to the original abstract, please click here.
More articles :

» Unite Against Scleroderma Event Scheduled For May 5th, 2013

is a rare, autoimmune, connective tissue disease characterized by the overproduction of collagen, which results in the thickening and hardening of the underlying connective tissues which support the skin, blood vessels, muscles, and internal organs...

» June Is Scleroderma Awareness Month!

The month of June is Scleroderma Awareness Month around the world, and would like to encourage each and everyone of you, to become advocates by raising awareness and educating others about this often progressive, autoimmune connective tissue disease...

» L-selectin and Skin Damage in Systemic Sclerosis

L-selectin ligands are induced on the endothelium of inflammatory sites. L-selectin expression on neutrophils and monocytes may mediate the primary adhesion of these cells at sites of inflammation by mediating the leukocyte-leukocyte interactions...

» What Is Vitiligo?

According to the Staff, Vitiligo (vit-ih-LI-go) is a condition in which your skin loses , the pigment that determines the color of your skin, hair and eyes. Vitiligo occurs when the cells that produce melanin die or no longer form melanin, causing...

» U.S. Legislation Passed to Promote Research and Awareness of Scleroderma

(U.S.) has applauded the U.S. House of Representatives for the passage of the Scleroderma Research and Awareness Act (H.R. 2408), introduced last March by Rep. Lois Capps (D-CA) and Rep. Vern Ehlers (R-MI). This bipartisan legislation gives hope to...

» Calcinosis

Background:The Foundation has recently received some feedback from some members of the public asking for more information regarding the condition known as Calcinosis. As part of our efforts we sought to provide a brief, yet informative insight into...