title: Autoimmune collagen vascular diseases: Kids are not just little people.
abstract: Morphea, dermatomyositis (DM), and discoid lupus erythematosus (DLE) are autoimmune collagen vascular diseases that can present at any age. In all three of these diseases, the tenants of diagnosis and treatment are largely the same in both children and adults, with a few notable differences. Children with morphea are more likely to present with the linear subtype and have a higher incidence of extracutaneous manifestations. Children often need early aggressive systemic treatment to try to prevent long-term sequelae of morphea. In DM, adult disease has a clear association with malignancy that is not seen in children. Adults have a higher rate of pulmonary involvement and increased mortality, whereas calcinosis is more common in juvenile DM. DLE in adults is generally considered to have a low rate of progression from discoid lesions alone to systemic lupus erythematosus (SLE). DLE is less common in children, but several studies have suggested a higher rate of progression from DLE to SLE in children compared with adults.
authors.affiliation: Resident, Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA.
authors.forename: Sean
authors.initials: S
authors.lastname: Timpane
authors.affiliation: Assistant Professor, Department of Pediatrics, Division of Dermatology, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA.
authors.forename: Heather
authors.initials: H
authors.lastname: Brandling-Bennett
authors.affiliation: Assistant Professor of Dermatology, University of Connecticut School of Medicine, Farmington, CT.
authors.forename: Arni K
authors.initials: AK
authors.lastname: Kristjansson
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003882:Dermatomyositis / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007223:Infant; D007231:Infant, Newborn; D008179:Lupus Erythematosus, Discoid / Q000175:diagnosis* / Q000188:drug therapy; D011701:PUVA Therapy; D011379:Prognosis; D012594:Scleroderma, Localized / Q000175:diagnosis* / Q000628:therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents