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 :

» Knowing Your Rheumatologist

Rheumatologists treat over 100 different forms of rheumatic diseases, arthritis and other diseases of the joints, muscles and bones. In addition to specializing in the diagnosis and treatment of these diseases, they are also care leaders, cost...

» Our Donors

The Scleroderma Care Foundation wishes to express our appreciation and gratitude for the generosity and support extended to us, by all of our donors to date, and the list keeps on growing. Your contributions have all been incredibly helpful and...

» Curcumin May Have Therapeutic Value In Treating Scleroderma

Turmeric, a shrub related to ginger, is grown throughout India, other parts of Asia, and Africa. It is well known for its warm, bitter taste and golden yellow color. Turmeric is commonly used in fabric dyes and foods such as curry powders, mustards,...

» Raynaud's Syndrome

John W. Hallett, Jr., MDJanuary 2008Raynaud's syndrome is vasospasm of parts of the hand in response to cold or emotional stress, causing reversible discomfort and color changes (pallor, cyanosis, erythema, or a combination) in one or more digits....

» Musculoskeletal Rehabilitation in the Person with Scleroderma

Janet L. PoolePosted: 03/12/2010; Curr Opin Rheumatol. 2010;22(2):205 © 2010 Lippincott Williams & WilkinsAbstractPurpose of Review: The purpose of this review is to examine current evidence for the efficacy of rehabilitation techniques for...

» Scleroderma and Massage Therapy

In a recent patient group meeting, we had the immense pleasure and honour of sitting with Rinalda, a local massage therapist, to discuss the importance of massage therapy and how it can help with our Scleroderma.Rinalda noted that from the beginning...