Management of localized scleroderma

Abstract

Localized scleroderma denotes a spectrum of conditions characterized by circumscribed fibrotic areas involving different levels of the dermis, subcutis, and sometimes underlying soft tissue and bone. Although the clinical course of the disease is often benign, widespread lesions and disabling joint contractures may lead to significant complications. The pathogenesis of the different types of localized scleroderma is still unknown. Numerous therapeutic agents have been reported to be effective in this disease spectrum, but controlled studies are rare. The purpose of this review is to summarize previous experience and to discuss recent advances in the management of localized scleroderma.

Esclerodermia localizada na criança: aspectos clínicos, diagnósticos e terapêuticos

“…53 A US de 20MHz permite a determinação da profundidade e da extensão da esclerose na área afetada. 56 Em pacientes pediátricos, pode mostrar a perda de gordura subcutânea e de músculo, aumento do fluxo sanguíneo e aumento da ecogenicidade, por condensação do colá-geno na derme. A hiperemia e o aumento de ecogenicidade parecem ser sinais de lesões ativas.…”

“…Em lesões pruriginosas, pode-se recorrer à capsaicina tópica. 56 Quando a lesão aumenta rapidamente ou envolve funcionalmente áreas importantes, a terapia sistêmica deve ser indicada. Nesses casos, corticosteroides orais são a primeira escolha.…”

Clinical immunology Interleukin 1β in morphea

“…Moreover, not many placebo-controlled multicentre trials are conducted, which could confirm efficacy of such approaches. Currently, the most accepted method is to use phototherapy, methotrexate and glucocorticoids [3,[25][26][27]. Obviously, one has to keep in mind the potentially self-restricting course of the disease and the fact that in most cases of MEP it does not seem reasonable to use treatments other than emollients.…”

“…Obviously, one has to keep in mind the potentially self-restricting course of the disease and the fact that in most cases of MEP it does not seem reasonable to use treatments other than emollients. The treatment should not pose higher risk for a patient than the disease itself [3,[25][26][27].…”

Operative Korrektur einer Sklerodermie en coup de sabre durch En-bloc-Resektion

“…Die Ätiologie dieses Krankheitsbildes ist bislang ungeklärt. Konservative therapeutische Ansät-ze sind sehr variabel und schließen die topische und die intraläsionale Anwendung von Glukokortikosteroiden [7], topisches Calcipotriol als Monotherapie [2] oder in Kombination mit einer UVA 1 -Phototherapie [8] oder PUVA-Cremetherapie ein [5].…”