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 :

» Our First Year Anniversary

Celebrating an important anniversary is always a blessing. The Scleroderma Care Foundation was officially incorporated on 15th October 2008. Its mission to provide support and education for persons afflicted with within Trinidad and Tobago became a...

» What's Your Scleroderma Action Plan?

Living with any serious disease or condition like Scleroderma, is without a doubt, difficult. It is not hard to understand either, that we often can lose sight of what is important, including our way. We may also fall into to a false sense of...

» Beware of Skin Signs of Illness and Disease

While moisturizers and make-up, facial peels and Botox can make our skin look beautiful and young, sometimes the external skin discolorations, blemishes, blotches or other unsightly marks we seek to remove are actually signs of an underlying...

» New Site For Adult Stem Cell Resources Launched

A new website is detailing success stories in adult stem cell research. is part of a campaign to educate and spread awareness about the potentials and successes of adult stem cell therapies, and was created by the Family Research Council and...

» What Are The Odds Of Having A Rare Disease?

There are over 7,000 known rare disorders or diseases, a statistic which is continually growing as medical science advances. The European Union's definition of a rare disorder or disease is a condition which affects 5 or less people in every 10,000....

» Dealing With Your Insomnia

Difficulty sleeping, also called insomnia, is a common and frustrating problem. If you are not sleeping well at night, it can be difficult to feel well during the daytime. Insomnia makes everything worse; it can lead to fatigue, depression, anxiety,...