Congenital localized scleroderma.
OBJECTIVE
Juvenile localized scleroderma (JLS) usually has its onset during later childhood. This report describes the clinical and serologic features of six children with congenital localized scleroderma (CLS).


METHODS
A large, multinational study was conducted among pediatric rheumatology and dermatology centers by collecting information on demographics, family history, triggering environmental factors, clinical features, laboratory reports, and treatment of patients with JLS. Patients with onset at birth were carefully examined.


RESULTS
Among 750 patients with JLS, 6 patients (0.8%) had scleroderma-related lesions at birth. Female-to-male ratio was 2:1. All patients had linear scleroderma, in four involving the face with en coup de sabre appearance. Two patients were misdiagnosed as having skin infection, one nevus, one salmon patch, and two undefined skin lesions. The mean diagnostic delay was 3.9 years. In comparison with the group of 733 patients with late-onset JLS, CLS presented a significantly more prolonged disease duration at diagnosis and a higher frequency of en coup de sabre subtypes.


CONCLUSIONS
Congenital localized scleroderma is a rare and probably underestimated condition in neonates. The linear subtype was the exclusive manifestation of the disease. CLS should be included in the differential diagnosis of infants with cutaneous erythematous fibrotic lesions to avoid functional and aesthetic sequelae and to allow prompt therapy.
Zulian
Francesco
F
Department of Pediatrics, University of Padua, Italy. zulian@pediatria.unipd.it
Vallongo
Cristina
C
de Oliveira
Sheila Knupp Feitosa
SK
Punaro
Marilynn G
MG
Ros
Joan
J
Mazur-Zielinska
Henryka
H
Galea
Paul
P
Da Dalt
Liviana
L
Eichenfield
Lawrence F
LF
D001284:Atrophy / Q000473:pathology; D001706:Biopsy; D002614:Chelating Agents / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D008727:Methotrexate / Q000627:therapeutic use; D010396:Penicillamine / Q000627:therapeutic use; D012594:Scleroderma, Localized / Q000151:congenital* / Q000175:diagnosis* / Q000188:drug therapy; D012867:Skin / Q000473:pathology
D002614:Chelating Agents; D007166:Immunosuppressive Agents; D010396:Penicillamine; D008727:Methotrexate