Faculty Collaboration Database

Discordance of pediatric morphea treatment by pediatric dermatologists. Pediatr Dermatol 2018 Jan;35(1):47-54

Date

11/23/2017

Pubmed ID

29165838

DOI

10.1111/pde.13281

Scopus ID

2-s2.0-85034780679 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

BACKGROUND/OBJECTIVES: Studies describing treatment efficacy in pediatric morphea are lacking. Subspecialists have reached no consensus on how to optimally treat pediatric morphea. The objective of the current study was to describe the most common treatment practices of pediatric dermatologists worldwide who care for children with morphea.

METHODS: A survey regarding topical treatment practices of pediatric morphea, with representative case-based scenarios, was distributed to pediatric dermatologists and results were tallied.

RESULTS: The survey response rate was 13.4%, with 110 respondents in the final analysis. The majority of respondents agreed on red violaceous rim (99%), increased local warmth (75%), raised borders (69%), and dermal thickening (64%) as signs of disease activity. Respondents had less agreement on sclerotic lesions (41%), scaling (43%), dyspigmentation (19%), and atrophy (13%) as signs of disease activity. Ninety-two percent of respondents used primary therapy or monotherapy with topical medications, including 45% in linear morphea of the limbs and 37% in linear morphea of the head or neck. High-potency topical corticosteroids were most commonly used (80%), although respondents did not agree on specific regimens. Sixteen different treatment regimens were selected as first-line therapy for one case scenario of active disease.

CONCLUSION: The survey found large variation in how pediatric dermatologists treat pediatric morphea. Consensus treatment guidelines developed by pediatric dermatologists and pediatric rheumatologists are urgently needed regarding the efficacy of therapies for pediatric morphea. Prospective studies of treatment efficacy in pediatric morphea are urgently needed as well.

Author List

Tollefson MM, Chiu YE, Brandling-Bennett HA, Pope E

Author

Yvonne E. Chiu MD Vice Chair, Professor in the Dermatology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Administration, Topical
Child
Child, Preschool
Dermatologic Agents
Dermatologists
Female
Humans
Male
Practice Patterns, Physicians'
Scleroderma, Localized
Surveys and Questionnaires