Successful treatment of children with juvenile systemic sclerosis using mycophenolate mofetil after methylprednisolone pulse therapy: A 3‐year follow‐up

Abstract

We read with great interest the article titled "Long-term efficacy and tolerability of mycophenolate mofetil [MMF] therapy in diffuse scleroderma skin disease", 1 recently published in this journal. The article suggested that MMF was associated with modest improvements in skin score and was well tolerated in treating adult-onset diffuse scleroderma skin disease. Regarding juvenile systemic sclerosis (JSSc), the best treatment strategy remains unclear, owing to the rarity of the disease. Herein, we report 2 cases of JSSc treated with MMF after methylprednisolone pulse therapy (MPT).A previously healthy 15-year-old Japanese boy (Case 1) was referred to our hospital with scleroderma affecting the bilateral finger to the forearm. He experienced chilblains for about a year before visiting our hospital. His hands felt uncomfortable. Furthermore, he experienced swelling and pain in his hands upon waking up. Physical examination revealed scleroderma affecting his finger to the forearm, with a modified Rodnan skin thickness score (mRSS) of 16. In addition, Raynaud's phenomenon, digital pitting scars, and telangi-