title: Prospective study to evaluate the clinical and radiological outcome of patients with scleroderma of the face.
abstract: BACKGROUND
  Scleroderma featuring rare connective tissue disease that manifests as skin sclerosis and variable systemic involvement. Two categories of scleroderma are known: systemic sclerosis, characterized by cutaneous sclerosis and visceral involvement and localized scleroderma or morphea which classically presents benign evolution and self-limited, confined to the skin and/or underlying tissue. Recent studies show that the localized form may possibly course with involvement of internal organs and variable morbidity. This study aimed to determine the demographic characteristics, the prevalence of systemic manifestations and laboratory findings, as well as the association with autoimmune diseases, and the evolution of neurological findings, both clinical as brain MRI in patients with scleroderma of the face and its relation with the activity skin.
  
  
  METHODS
  Patients with localized scleroderma with facial involvement were evaluated and underwent neurological examination, magnetic resonance imaging and ophthalmology evaluation. After 3years, the patients were subjected again to MRI.
  
  
  RESULTS
  We studied 12 patients with localized scleroderma of the face. Of this total, headache being the most frequent complaint found in 66.7% of patients, 33.3% had neurological changes possibly associated with scleroderma. As for ophthalmologic evaluation, 25% of patients showed abnormalities. The most frequent parenchymal finding was the presence of lesions with hyperintense or hypointense signal in 75% of patients, followed by ventricular asymmetry at 16.7%. Of the patients who had neurological deficits, 75% also had a change to MRI. In all patients, imaging findings after 3years were unchanged. During this interval of 3years, 25% of patients showed signs of activity of scleroderma.
  
  
  CONCLUSIONS
  Patients with localized scleroderma of the face have a high prevalence of neurological and ophthalmological changes. Based on these findings, we suggest that all cases of localized scleroderma of the face should be thoroughly examined for the presence of systemic changes.
authors.affiliation: Department of Dermatology, University of Sao Paulo Medical School, Brazil. mfcareta@yahoo.com.br
authors.forename: Mariana Figueiroa
authors.initials: MF
authors.lastname: Careta
authors.forename: Claudia da Costa
authors.initials: Cda C
authors.lastname: Leite
authors.forename: Fernando
authors.initials: F
authors.lastname: Cresta
authors.forename: Jose
authors.initials: J
authors.lastname: Albino
authors.forename: Mirian
authors.initials: M
authors.lastname: Tsunami
authors.forename: Ricardo
authors.initials: R
authors.lastname: Romiti
mesh_terms: D001327:Autoimmune Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000276:immunology; D003094:Collagen / Q000378:metabolism; D005145:Face / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D015995:Prevalence; D011446:Prospective Studies; D011859:Radiography; D012594:Scleroderma, Localized / Q000150:complications* / Q000000981:diagnostic imaging / Q000276:immunology; D012867:Skin / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D003094:Collagen
keywords: Collagen's disease; Localized scleroderma of the face; Magnetic resonance image; Neurological disorders; Ophthalmologic disorders; Systemic involvement