title: Localized scleroderma: a series of 52 patients.
abstract: BACKGROUND
  Localized scleroderma also called morphea is a skin disorder of undetermined cause. The widely recognized Mayo Clinic Classification identifies 5 main morphea types: plaque, generalized, bullous, linear and deep. Whether each of these distinct types has a particular clinical course or is associated with some patient-related features is still unclear.
  
  
  METHODS
  We report here a retrospective series of patients with localized scleroderma with an attempt to identify features related to the type of lesion involved. The medical records of all patients with a diagnosis of localized scleroderma were reviewed by skilled practitioners. Lesions were classified according to the Mayo Clinic Classification. The relationship between each lesion type and various clinical features was tested by non-parametrical methods.
  
  
  RESULTS
  The sample of 52 patients included 43 females and 9 males. Median age at onset was 30 y (range 1-76). Frequencies of patients according to morphea types were: plaque morphea 41 (78.8%) (including morphea en plaque 30 (57.7%) and atrophoderma of Pasini-Pierini 11 (21.1%)), linear scleroderma 14 (26.9%). Nine patients (17.3%) had both types of localized scleroderma. Median age at onset was lower in patients with linear scleroderma (8 y (range 3-44)) than in others (36 y (range 1-77)) (p=0.0003). Head involvement was more common in patients with linear scleroderma (37.5%) than in other subtypes (11.1%) (p=0.05). Atrophoderma of Pasini-Pierini was never located at the head. Systemic symptoms, antinuclear antibodies and the rheumatic factor were not associated with localized scleroderma types or subtypes.
  
  
  CONCLUSIONS
  These results suggest that morphea types, in adults are not associated with distinct patient features except for age at disease onset (lower) and the localization on the head (more frequent), in patients with lesions of the linear type.
authors.affiliation: Department of Internal Medicine Centre Hospitalo-Universitaire Saint-Antoine, 75012 Paris, Assistance Publique/Hôpitaux de Paris, France. cecile.toledano@sat.ap-hop-paris.fr
authors.forename: C
authors.initials: C
authors.lastname: Toledano
authors.forename: S
authors.initials: S
authors.lastname: Rabhi
authors.forename: A
authors.initials: A
authors.lastname: Kettaneh
authors.forename: B
authors.initials: B
authors.lastname: Fabre
authors.forename: L
authors.initials: L
authors.lastname: Fardet
authors.forename: K P
authors.initials: KP
authors.lastname: Tiev
authors.forename: J
authors.initials: J
authors.lastname: Cabane
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005355:Fibrosis; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012594:Scleroderma, Localized / Q000145:classification* / Q000188:drug therapy / Q000473:pathology*; D012867:Skin / Q000473:pathology*; D013256:Steroids / Q000627:therapeutic use; D040521:Subcutaneous Tissue / Q000473:pathology; D055815:Young Adult
chemical_list: D013256:Steroids