Diagnosis and treatment of systemic and localized scleroderma

Khanna, Dhanita

doi:10.1586/edm.11.26

Cited by 13 publications

(11 citation statements)

References 69 publications

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“…The limitations of our study include the small number of patients, the lack of a control group and the short duration of treatment. In future studies, the follow-up phase must be prolonged to allow for the definition of the optimal treatment period and determination whether 8% pirfenidone gel has met the objectives for patients with localized scleroderma (that is, by improving the lesions, delaying their progress and preventing permanent disability and cosmetic damage) [ 22 , 24 ]. We consider that pirfenidone can be a promising therapeutic agent for localized scleroderma.…”

Section: Discussionmentioning

confidence: 99%

Pirfenidone gel in patients with localized scleroderma: a phase II study

Rodríguez‐Castellanos

Tlacuilo‐Parra²,

Sánchez‐Enríquez

et al. 2014

Arthritis Res Ther

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IntroductionLocalized scleroderma is an inflammatory disease in its first stages and a fibrotic process in later stages, principally mediated by the transforming growth factor β. To date, there is no standard treatment. The objective of this study was to determine the effectiveness and safety of 8% pirfenidone gel in patients with localized scleroderma.MethodsThis was an open phase II clinical trial that included 12 patients. Treatment with pirfenidone was indicated, three times daily for 6 months. Patients were evaluated clinically with the modified Localized Scleroderma Skin Severity Index (mLoSSI), as well with a durometer and histologically using hematoxylin and eosin stain and Masson’s trichrome stain.ResultsThe baseline mLoSSI average scores were 5.83 ± 4.80 vs. 0.83 ± 1.75 (P = 0.002) at 6 months. The initial durometer induration of the scleroderma plaques was 35.79 ± 9.10 vs. 32.47 ± 8.97 at 6 months (P = 0.05). We observed histopathological improvement with respect to epidermal atrophy, inflammation, dermal or adipose tissue fibrosis and annex atrophy from 12.25 ± 3.25 to 9.75 ± 4.35 (P = 0.032). The 8% pirfenidone gel application was well tolerated, and no side effects were detected.ConclusionsThis is the first study on the therapeutic use of pirfenidone gel in localized scleroderma. It acts on both the inflammatory and the fibrotic phases. Considering its effectiveness, good safety profile and the advantage of topical application, pirfenidone is a treatment option in this condition.

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Section: Discussionmentioning

confidence: 99%

Pirfenidone gel in patients with localized scleroderma: a phase II study

Rodríguez‐Castellanos

Tlacuilo‐Parra²,

Sánchez‐Enríquez

et al. 2014

Arthritis Res Ther

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“…Laboratory investigations are supportive. 11 Autoantibodies are seen in approximately 95% of patients with scleroderma and more than 30 specificities have been described. Most of these can be detected with screening antinuclear antibody (ANA) using indirect immunofluorescence.…”

Section: Discussionmentioning

confidence: 99%

A neoteric multidrug combination: novel approach to limited cutaneous systemic scleroderma involving the face

Kumar¹,

Ms²,

Sh³

et al. 2016

BMJ Case Reports

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Limited cutaneous scleroderma is a subtype of scleroderma limited to the skin of the face, hands, feet and forearms. We present a case of a 45-year-old woman affected by limited cutaneous systemic scleroderma involving the orofacial region and causing restricted mouth opening. The patient showed noteworthy improvement of the skin lesion by use of a combination of intralesional corticosteroid with hyaluronidase and various multiantioxidants, resulting in amelioration of her mouth opening problem. The patient gave her full informed written consent to this report being published.

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“…Yearly cost for each SSc patient in USA and Canada are estimated around 140─200 million, related with younger age, disease severity level, disease activity and bad health status. [11][12][13] Polymorphism in the gene level, has a major role in individual vulnerability to SSc. 14 In accordance to "treat to target" philosophy, it is important to know the exact method to measure disease activity in SSc.…”

Section: Indonesian Journal Of Rheumatologymentioning

confidence: 99%

“…14 In accordance to "treat to target" philosophy, it is important to know the exact method to measure disease activity in SSc. [11][12][13] Clinical parameter such as skin fibrosis degree, changes in organ involvement and laboratory parameter which describe inflammation activity, immune activity, fibrosis and vascular can be used to measure disease activity in SSc. 15 Modified Rodnan Skin Score (mRSS) is a tool in assessing skin fibrosis degree which already proven in several clinical trial and well corelated with skin biopsy.…”

Section: Indonesian Journal Of Rheumatologymentioning

confidence: 99%

The Correlation Value of DAS28 with Anti-CCP Titer on Rheumatoid Arthritis Patients in Cipto Mangunkusumo Hospital in 2012-2016

Isbagio

Fadillah²

2018

Ina J Rheum

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Background: Rheumatoid Arthritis (RA) is one of the diseases associated with the immune system which causes joint damage and effect to the quality of patient’s life. DAS28 CRP value describes RA disease activity. The anti-CCP titer is a very specific examination which provide an overview prognosis of RA patient’s illness. The research on the correlation of anti-CCP Titers with DAS28 CRP values has never been done in Indonesia. Therefore, this research aims to determine the correlation between anti-CCP Titer and DAS28 CRP value in RA patient in Cipto Mangunkusumo hospital with DAS28 CRP value in RSCM. Method: The research design is cross-sectional with the sample amounted to 34. anti-CCP and DAS28 CRP were obtained through patient’s medical records.Result The result of this correlationstudy is (p = 0,582) and r = 0,086. Conclusion: In conclusion, there is no correlation between anti-CCP and DAS28 in Cipto Mangunkusumo hospital. Keywords: Anti-CCP; DAS28 CRP; Rheumatoid Arthritis

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Diagnosis and treatment of systemic and localized scleroderma

Cited by 13 publications

References 69 publications

Pirfenidone gel in patients with localized scleroderma: a phase II study

Pirfenidone gel in patients with localized scleroderma: a phase II study

A neoteric multidrug combination: novel approach to limited cutaneous systemic scleroderma involving the face

The Correlation Value of DAS28 with Anti-CCP Titer on Rheumatoid Arthritis Patients in Cipto Mangunkusumo Hospital in 2012-2016

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