Background: Prospective, longitudinal studies examining the features of linear morphea are limited. Objective: To utilize the Morphea in Adults and Children cohort to determine clinical characteristics, impact on life quality, and disease course of linear morphea in a prospective, longitudinal manner. Methods: Characteristics of linear morphea versus other subtypes were compared in a cross-sectional manner. Next, linear morphea participants were examined in depth over a 3-year period. Results: Linear morphea was the most common morphea subtype (50.1%, 291/581) in the cohort. Deep involvement was more common in linear (64.3%, 187/291) than other morphea subtypes. Linear morphea participants with deep involvement were more likely to have a limitation in range of motion (28.6%, 55/192) than those without (11.1%, 11/99, P \ .001). Adult-onset disease occurred in 32.6% (95/291) of those with linear morphea. Frequency of deep involvement was similar between pediatric (66.8%, 131/196) and adult-onset linear morphea (58.9%, 56/95, P = .19). Quality of life and disease activity scores improved over time, while damage stabilized with treatment. Limitations: Results of the study are associative, and the University of Texas Southwestern Medical Center is a tertiary referral center. Conclusion: A substantial number of linear morphea patients have adult-onset disease. In all age groups, linear morphea with deep involvement was associated with functional limitations.

Background Although the inclusion of arts in medical school curricula has garnered attention, little is known about the effect of arts-based interventions on the behaviors, attitudes, and technical skills of students. The Art of Observation is an optional elective at the University of Texas Southwestern Medical Center (UTSW) in collaboration with educators from the Dallas Museum of Art (DMA). We utilized a qualitative approach to describe in-depth how engaging with art influences the development of medical students’ observation skills and empathy. Methods We analyzed evaluations from 65 medical students who completed the course between 2015 and 2017. Evaluations contained open-ended questions that asked students to reflect upon their experiences and describe their perceptions, thoughts, and feelings after guided museum visits. We used grounded theory to generate a thematic codebook, then employed axial coding to discover thematic relationships. Results We report three main findings and several subthemes: (1) Enhanced observation skills: by engaging with art and completing relevant activities, students developed the ability to synthesize a compelling narrative in addition to learning technical skills; (2) Improved physician socialization: students reported enhanced self-awareness, increased tolerance of ambiguity, and development of a humanistic view of medicine, key components of physician socialization; and (3) Reduction in burnout symptoms: students reported an enhanced sense of well-being after each session, which mitigates the process of burnout. Conclusions Fine arts can be used to teach technical skills, stimulate personal reflection, and prevent burnout. A meaningful engagement with the arts can play an important role in developing physicians who are observant, empathetic, and more well-rounded. Electronic supplementary material The online version of this article (10.1186/s12909-019-1671-2) contains supplementary material, which is available to authorized users.

IMPORTANCEFirst-line systemic therapy for morphea includes methotrexate with or without systemic corticosteroids. When this regimen is ineffective, not tolerated, or contraindicated, a trial of mycophenolate mofetil (MMF) or mycophenolic acid (MPA)-referred to herein as mycophenolate-is recommended; however, evidence to support this recommendation remains weak.OBJECTIVE To evaluate the effectiveness and tolerability of mycophenolate for the treatment of morphea.

IMPORTANCE Numerous classification systems for morphea subtypes exist, but none have been systematically evaluated for their ability to categorize patients with morphea into demographically and clinically coherent groups. Although some subtypes, such as linear morphea, are present across all the classification schemes, others list unique subtypes. This creates confusion among investigators and practitioners and impairs accurate categorization of patients for study and clinical evaluation.OBJECTIVE To evaluate how frequently the commonly used morphea classification systems categorize patients with morphea into clinically relevant subtypes using cross-sectional analysis of 2 large patient cohorts.

No abstract