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Linear scleroderma in an adolescent woman treated with methotrexate and excimer laser

2014; Wiley; Volume: 27; Issue: 4 Linguagem: Inglês

10.1111/dth.12117

1529-8019

Anne H. Hanson, David Fivenson, Brian Schapiro,

Skin Diseases and Diabetes

Dermatologic TherapyVolume 27, Issue 4 p. 203-205 Therapeutic Hotline Linear scleroderma in an adolescent woman treated with methotrexate and excimer laser Anne H. Hanson, Corresponding Author Anne H. Hanson Department of Dermatology, Saint Joseph Mercy Hospital, Ann Arbor, MichiganAddress correspondence and reprint requests to: Anne Hanson, DO, Saint Joseph Mercy Hospital, Reichert Health Center, 5333 McAuley Drive Suite 5003, Ypsilanti, MI 48197, or email: ahhanson@gmail.com.Search for more papers by this authorDavid P. Fivenson, David P. Fivenson Department of Dermatology, Saint Joseph Mercy Hospital, Ann Arbor, MichiganSearch for more papers by this authorBrian Schapiro, Brian Schapiro Department of Dermatopathology, Saint Joseph Mercy Hospital, Ann Arbor, MichiganSearch for more papers by this author Anne H. Hanson, Corresponding Author Anne H. Hanson Department of Dermatology, Saint Joseph Mercy Hospital, Ann Arbor, MichiganAddress correspondence and reprint requests to: Anne Hanson, DO, Saint Joseph Mercy Hospital, Reichert Health Center, 5333 McAuley Drive Suite 5003, Ypsilanti, MI 48197, or email: ahhanson@gmail.com.Search for more papers by this authorDavid P. Fivenson, David P. Fivenson Department of Dermatology, Saint Joseph Mercy Hospital, Ann Arbor, MichiganSearch for more papers by this authorBrian Schapiro, Brian Schapiro Department of Dermatopathology, Saint Joseph Mercy Hospital, Ann Arbor, MichiganSearch for more papers by this author First published: 18 February 2014 https://doi.org/10.1111/dth.12117Citations: 6 Author Contributions: Dr(s) Hanson, Fivenson, Schapiro had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Funding/Support: This study was supported in part by: unfunded. Role of the Sponsors: No sponsor Financial Disclosure: Relationships relevant to this manuscript: none. All other relationships: none. Funding/Support: This study was supported in part by: none. Conflicts of interest: For all authors listed, there are no relevant financial interests related to the study subject. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract A 17-year-old Caucasian woman presented for evaluation and treatment of a tender expanding linear plaque on her left flank. Biopsy findings were consistent with morphea. Treatment initially included intralesional steroid injections and topical calcipotriene ointment, followed by methotrexate and excimer laser. The lesion decreased in size considerably with relief of symptomatic discomfort by 7 months. An excisional biopsy of a persistent eroded papule on the superior aspect of the morphea plaque revealed dermal thickening and sclerosis with superimposed perforation of a calcified nodule. Localized scleroderma, or morphea, is an autoimmune disease of the skin and underlying subcutaneous tissue primarily affecting the pediatric population. The excimer laser has been reported to effectively treat a variety of dermatologic conditions, including morphea. Its mechanism of action may be via depletion of T cells, altering apoptosis-mediating molecules and decreasing cytokine expression. Methotrexate is also useful for the acute and deep forms of morphea and has been shown to decrease levels of inter leukins-2 and -6, tenascin, and mast cells. This patient had a good clinical response with a combination of these two modalities. The epidermal perforation with transepidermal elimination of calcified necrotic collagen is a unique complication that may have been secondary to this combination treatment modality. Citing Literature Volume27, Issue4July/August 2014Pages 203-205 RelatedInformation