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Study: Morphea, systemic sclerosis likely separate diseases
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Although symptoms common to systemic sclerosis are frequently seen in patients with morphea, it is likely that the two are separate diseases, according to research conducted in four French academic dermatology departments.
Researchers studied 58 women and 18 men with a median age of 59 years and mean age at diagnosis of 54 years. Plaque morphea was seen in 49 patients, linear morphea was seen in 18 patients and generalized morphea was seen in nine patients. Diagnosis was confirmed with biopsy in 26 patients. A control group comprised 101 healthy individuals matched for age and sex.
All participants were screened for symptoms of systemic sclerosis, such as Raynaud's phenomenon, telangiectasia, visible nailfold capillaries, sclerodactyly, digital ulcers or scars, sicca syndrome, dyspnea and signs of acid reflux. In the presence of symptoms, appropriate clinical and laboratory tests were performed. Capillaroscopy or nailfold examination was performed with a dermatoscope by an experienced clinician. A diagnosis of scleroderma was made after patients met American College of Rheumatology criteria.
Four patients in the control group and eight patients in the group with morphea presented with symptoms that were potentially indicative of systemic sclerosis - a difference that was not statistically significant, according to the researchers. Three patients with morphea had Raynaud's phenomenon, two had acrosclerosis, one had subcutaneous calcinosis and one had regurgitation. Lung involvement was not seen in any patients.
Within the control group, Raynaud's phenomenon was seen in two participants, telangiectasias was seen in two participants and reflux was seen in one participant. The two patients with Raynaud's phenomenon and telangiectasias had anti-neutrophil cytoplasmic antibody-positive vasculitis. No other clinical symptoms were seen in the patients after chest CT scan, functional lung tests and other tests were performed, according to the researchers.
None of the patients with morphea developed systemic sclerosis after mean disease duration of 8 years. Many patients had severe and widespread morphea, suggesting that there was no overlap between the two conditions, according to the researchers. - by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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