Pediatric Morphea (Localized Scleroderma)-Epidemiological, Clinical and Laboratory Findings of 14 Cases

Background and Design: Morphea is an inflammatory skin disease seen more frequently than systemic sclerosis in pediatric patients. Important functional deficiencies and cosmetic deformities may develop especially due to linear morphea. Patients may have accompanying extracutaneous involvement, family history of rheumatologic diseases and abnormalities in laboratory parameters like positive ANA and RF. It is important to evaluate pediatric patients accordingly and to carry out further examinations. Data about pediatric morphea in Turkish population could not be found in the literature. We aimed to evaluate epidemiological, clinical and laboratory findings, to compare the data with those in the literature and to propose a model for Turkish pediatric morphea which can be supported by future multicenter national studies. Materials and Methods: Fourteen pediatric morphea patients, 3 males and 11 females under the ageof 18, followed up at Uludag University, Medical Faculty, Dermatovenereology Department between 2000-2010 were enrolled in the study. Inclusion criterion was age under 18 years at diagnosis. Epidemiological, clinical and laboratory findings were analyzed retrospectively. Results: Only 3 patients were males. The mean age at disease onset was 9.5 years. The mean duration of disease was 21 months. Most frequent type was linear morphea. Two patients had contracture, one had shortness in the left lower extremity, and 4 patients had livedo reticularis. Raynaud's phenomenon was positive in one case. Trauma and sunburn were the trigger factors detected. Behcets disease was reported in the father of one patient. One case was RF positive. Five patients had positive ANA in titers of 1/100, while a patient with generalised morphea had significantly higher titer (1/1000). Antihistone antibodies were positive in one patient and 2 cases were Lyme IgM positive. Conclusion: Early diagnosis and therapy are important since childhood morphea can cause cosmetic deformities. Patients should be evaluated for accompanying systemic symptoms and, extracutaneous involvement should be investigated when the disease is suspected. (Turkderm 2011; 45:132-6)