Physical Burden of Symptoms in Patients With Localized Scleroderma and Eosinophilic Fasciitis

Kroft, E.B.M.; Jong, E.M.G.J. de; Evers, Andrea W M

doi:10.1001/archderm.144.10.1394

Cited by 19 publications

(27 citation statements)

References 6 publications

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“…Moreover, the presence of any symptoms was associated with greater patient-perceived negative impact on life quality for both adults and children. Our results are similar to those of Kroft et al, 12,13 who noted fatigue, pain, and itch were significant correlates of DLQI. They also reported patients with generalized morphea have anxiety and depression comparable with that of psychiatric outpatients.…”

Section: Discussionsupporting

confidence: 92%

“…Even fewer studies examine the impact of morphea in adults. To date, Kroft et al 12,13 are the only authors to report the psychological and physical impact of morphea in adults; however, their cohort comprises only 74 patients. This gap in knowledge may hinder optimal patient care because physician-based measures may not adequately reflect patients' perceptions of severity and therapeutic outcomes.…”

mentioning

confidence: 99%

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Correlates of self-reported quality of life in adults and children with morphea

Das

Bernstein

Jacobe

2014

Journal of the American Academy of Dermatology

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Background Determining a disease's impact on life quality is important in clinical decision making, research, and resource allocation. Determinants of quality of life (QOL) in morphea are poorly understood. Objective We sought to ascertain demographic and clinical variables correlated with negative impact on self-reported QOL in morphea. Methods We conducted a cross-sectional survey of the Morphea in Adults and Children cohort. Results Symptoms (pruritus and pain) and functional impairment were correlated with decreased QOL in children and adults. This was true in both sexes and was independent of subtype and age. Patient-reported QOL correlated with physician-based measures of disease severity in adults, but not in children. Patients with linear and generalized morphea had the greatest impact on QOL. Limitations Small sample size is a limitation. Conclusion Symptoms and functional impairment were determinants of impaired life quality in both children and adults independent of morphea subtype. These results suggest that clinicians should consider suppressing the accumulation of new lesions (when rapidly accumulating) and symptoms (pain and pruritus) in the treatment of patients with morphea.

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

Correlates of self-reported quality of life in adults and children with morphea

Das

Bernstein

Jacobe

2014

Journal of the American Academy of Dermatology

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“…It affects both adults and children, often producing impairment of function, cosmesis, and quality of life (1–3). …”

Section: Introductionmentioning

confidence: 99%

Major Histocompatibility Complex Class I and Class II Alleles May Confer Susceptibility to or Protection Against Morphea: Findings From the Morphea in Adults and Children Cohort

Jacobe

Ahn

Arnett

et al. 2014

Arthritis & Rheumatology

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Objective To determine human leukocyte antigen class I (HLA-class I) and II (HLA-class II) alleles associated with morphea (localized scleroderma) in the Morphea in Adults and Children (MAC) cohort by a nested case–control association study. Methods Morphea patients were included from MAC cohort and matched controls from the NIH/NIAMS Scleroderma Family Registry and DNA Repository and Division of Rheumatology at the University of Texas Health Science Center at Houston. HLA- Class II genotyping and SSCP typing was performed of HLA-A, -B, -C alleles. Associations between HLA-Class I and II alleles and morphea as well as its subphenotypes were determined. Results There were 211 cases available for HLA-class I typing with 726 matched controls and 158 cases available for HLA Class-II typing with 1108 matched controls. The strongest associations were found with DRB1*04:04 (OR 2.3, 95% CI 1.4–4.0 P=0.002) and HLA-B*37 conferred the highest OR among Class I alleles (3.3, 95% CI 1.6–6.9, P= 0.0016). Comparison with risk alleles in systemic sclerosis determined using the same methods and control population revealed one common allele (DRB*04:04). Conclusion Results of the present study demonstrate specific HLA Class I and II alleles are associated with morphea and likely generalized and linear subtypes. The associated morphea alleles are different than in scleroderma, implicating morphea is also immunogenetically distinct. Risk alleles in morphea are also associated with conditions such as rheumatoid arthritis (RA) and other autoimmune conditions. Population based studies indicate patients with RA have increased risk of morphea, implicating a common susceptibility allele.

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“…Circumscribed morphea can be either superfi cial or deep. Because the superfi cial variant is limited to the epidermis and dermis, it was not included in the present problems, and irreversible functional impairment (6)(7)(8). Musculoskeletal manifestations should be carefully monitored in patients with LS, and the disease should be treated aggressively (9)(10)(11).…”

Section: Clinical Examination Protocolmentioning

confidence: 99%