title: Scleroderma in children: an update.
abstract: OBJECTIVE
  Scleroderma, in its localized and systemic presentation, represents the third most frequent rheumatic condition in childhood after juvenile idiopathic arthritis and systemic lupus erythematosus. Early diagnosis, appropriate assessment and effective treatment are crucial to improve the long-term outcome.
  
  
  RESULTS
  Recent studies, concerning histopathology and clinical associations with other conditions, open new horizons on the etiopathogenesis of scleroderma. New developments have been also reached in the field of outcome measures. In juvenile localized scleroderma (JLS), new techniques such as Doppler and laser Doppler imaging have shown their usefulness for the daily monitoring of the patients. In juvenile systemic sclerosis (JSSc), a new severity score has been developed and needs to be validated in future trials. Finally, a randomized, double-blind controlled trial, a multicenter consensus statement and long-term follow-up studies have confirmed the important role of methotrexate (MTX) for the treatment of JLS.
  
  
  CONCLUSIONS
  Studies over recent years highlighted the role of imaging as outcome measures for JLS and introduced a severity score for JSSc. New studies on MTX confirmed its important role for the treatment of JLS.
authors.affiliation: Division of Pediatric Rheumatology, Department of Pediatrics, University of Padua, Padua, Italy. zulian@pediatria.unipd.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Zulian
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cuffaro
authors.forename: Francesca
authors.initials: F
authors.lastname: Sperotto
mesh_terms: D002648:Child; D042241:Early Diagnosis; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D012594:Scleroderma, Localized / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D012595:Scleroderma, Systemic / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D008727:Methotrexate