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Alkanhal NA, AlKhodier H. Intraoral Involvement in Linear Scleroderma En Coup De Sabre: A Case Report. Cureus 2024; 16:e55886. [PMID: 38595865 PMCID: PMC11003326 DOI: 10.7759/cureus.55886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/11/2024] Open
Abstract
Localized scleroderma is a connective tissue disorder that causes excessive collagen deposition and skin fibrosis. It can be subdivided into morphea and linear scleroderma. En coup de sabre (ECDS) is a rare variant of linear scleroderma typically found among children. It is usually treated with methotrexate and corticotherapy in addition to folic acid supplements. To date, few cases of ECDS have been reported with oral involvement. This case report discusses a seven-year-old girl with linear scleroderma ECDS who was referred to the dental clinic to evaluate muscular hypotrophy on the floor of the mouth. Upon clinical and radiographic examination, the patient had hypotrophied mylohyoid muscle, reduced alveolar bone height on the affected side, and a deviated midline to the affected side as well. Furthermore, the patient was classified as having a high caries risk. After consultation with the primary physician regarding treatment modalities and options, the patient completed her comprehensive dental treatment at the Dental Department at King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia.
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Affiliation(s)
- Nuha A Alkanhal
- Pediatric Dentistry, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Haifa AlKhodier
- Pediatric Dentistry, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
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2
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J S, S L, Nair MV, R KT, Ramani P. Oral Submucous Fibrosis and Scleroderma: A Review of the Etiopathogenesis, Clinicopathological Correlation, and Management Aspects. Cureus 2023; 15:e44502. [PMID: 37791189 PMCID: PMC10544504 DOI: 10.7759/cureus.44502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
Oral submucous fibrosis (OSMF) is a chronic, progressive, insidious premalignant disease with multifactorial etiology affecting any part of the oral cavity and sometimes the pharynx by triggering a rapid onset of trismus and dysphagia due to stiffness at the lips, cheek, pharynx, and upper oesophageal region. Submucous fibrosis resembles many auto-immune, dermatological, mucocutaneous, and fibrotic lesions that include scleroderma, amyloidosis, iron deficiency anemia, and systemic or generalized fibromatosis clinically and histologically. Several authors established an association between oral submucous fibrosis and scleroderma with predominant oral manifestations on the basis of similarity in clinical and histological characteristics despite different pathogenesis and prognostic aspects. Scleroderma or systemic sclerosis is an autoimmune connective tissue disorder clinically manifested as fibrosis of the skin, blood vessels, and visceral organs with or without the involvement of the oral cavity. Thus, understanding the disease mechanism, appropriate early diagnosis, and clinical management of these two entities play an important role in disease prognosis and treatment outcomes. The present review was carried out to briefly present a concise overview of the etiopathogenesis, clinical, histological, diagnosis, and management aspects of OSMF and scleroderma based on the available literature, with special emphasis on similarities and differences between these two entities subsequently aiding in appropriate treatment planning.
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Affiliation(s)
- Sreedevi J
- Department of Oral Medicine and Radiology, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Lubnaz S
- Department of Oral Medicine and Radiology, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Maneesha V Nair
- Department of Oral Medicine and Radiology, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Karuna Thulasi R
- Department of Oral Medicine and Radiology, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Priya Ramani
- Department of Oral Medicine and Radiology, Thai Moogambigai Dental College and Hospital, Chennai, IND
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3
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Wang L, Lv S, Lin W, Yang D. Autologous Concentrated Growth Factor Used to Treat Linear Scleroderma En Coup de Sabre: A Case Report. Clin Cosmet Investig Dermatol 2022; 15:675-679. [PMID: 35444437 PMCID: PMC9015785 DOI: 10.2147/ccid.s356972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/01/2022] [Indexed: 11/23/2022]
Abstract
Linear scleroderma en coup de sabre (LSCS) is a variant of localized scleroderma associated with band-like fibrotic lesions in the frontoparietal area. We report a case of LSCS in a woman who presented with progressive mild hyperchromia on the right side of her forehead, with dermal atrophy and hair and eyebrow loss. After the failure of conservative treatments, the patient responded dramatically to injection of autologous localized concentrated growth factor. After three treatments, the atrophy, stiffness, and angiotelectasis on the affected area had improved. No recurrence was detected 24 months after the last treatment. This is the first study describing the use of autologous concentrated growth factor injection to alleviate clinical symptoms of LSCS. This suggests that concentrated growth factor may be a treatment for LSCS in the clinic.
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Affiliation(s)
- Lei Wang
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Shuying Lv
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, People's Republic of China.,School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Wenjun Lin
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, People's Republic of China.,School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Dingquan Yang
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, People's Republic of China
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4
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Del Pozzo-Magaña BR, Rieder MJ. Not every white spot is vitiligo. Paediatr Child Health 2022; 27:1-3. [DOI: 10.1093/pch/pxab050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/09/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Blanca R Del Pozzo-Magaña
- Department of Paediatrics, Children’s Hospital of Western Ontario, London, Ontario, Canada
- Division of Clinical Pharmacology, Western University and London Health Sciences Centre, London, Ontario, Canada
| | - Michael J Rieder
- Department of Paediatrics, Children’s Hospital of Western Ontario, London, Ontario, Canada
- Division of Clinical Pharmacology, Western University and London Health Sciences Centre, London, Ontario, Canada
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5
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Hixon AM, Christensen E, Hamilton R, Drees C. Epilepsy in Parry-Romberg syndrome and linear scleroderma en coup de sabre: Case series and systematic review including 140 patients. Epilepsy Behav 2021; 121:108068. [PMID: 34052630 DOI: 10.1016/j.yebeh.2021.108068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/27/2021] [Accepted: 05/06/2021] [Indexed: 11/25/2022]
Abstract
Parry-Romberg syndrome (PRS) and linear sclerosis en coup de sabre (LScs) are rare, related, autoimmune conditions of focal atrophy and sclerosis of head and face which are associated with the development of focal epilepsy. The scarcity of PRS and LScs cases has made an evidence-based approach to optimal treatment of seizures difficult. Here we present a large systematic review of the literature evaluating 137 cases of PRS or LScs, as well as three new cases with epilepsy that span the spectrum of severity, treatments, and outcomes in these syndromes. Analysis showed that intracranial abnormalities and epileptic foci localized ipsilateral to the external (skin, eye, mouth) manifestations by imaging or EEG in 92% and 80% of cases, respectively. Epilepsy developed before external abnormalities in 19% of cases and after external disease onset in 66% of cases, with decreasing risk the further from the start of external symptoms. We found that over half of individuals affected may achieve seizure freedom with anti-seizure medications (ASMs) alone or in combination with immunomodulatory therapy (IMT), while a smaller number of individuals benefitted from epilepsy surgery. Although analysis of case reports has the risk of bias or omission, this is currently the best source of clinical information on epilepsy in PRS/LScs-spectrum disease. The paucity of higher quality information requires improved case identification and tracking. Toward this effort, all data have been deposited in a Synapse.org database for case collection with the potential for international collaboration.
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Affiliation(s)
- Alison M Hixon
- Medical Scientist Training Program, University of Colorado, CU Anschutz Fitzsimons Building 13001 East 17th Place, Aurora, CO 80045, USA
| | - Elijah Christensen
- Medical Scientist Training Program, University of Colorado, CU Anschutz Fitzsimons Building 13001 East 17th Place, Aurora, CO 80045, USA
| | - Robert Hamilton
- Blue Sky Neurology, 499 E. Hampden Ave. Ste. 360 Englewood, CO 80113, USA
| | - Cornelia Drees
- Department of Neurology, University of Colorado, CU Anschutz Research Complex II, 12700 East 19th Avenue, Aurora, CO 80045, USA; Mayo Clinic Neurology and Neurosurgery, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA.
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Schutt C, Mirizio E, Salgado C, Reyes-Mugica M, Wang X, Chen W, Grunwaldt L, Schollaert KL, Torok KS. Transcriptomic Evaluation of Juvenile Localized Scleroderma Skin With Histologic and Clinical Correlation. Arthritis Rheumatol 2021; 73:1921-1930. [PMID: 33844442 DOI: 10.1002/art.41758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 04/01/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Juvenile localized scleroderma (LS) is an autoimmune disease of the skin whose pathogenesis is not well understood due to the rarity of the disease. This study was undertaken to determine the skin transcriptome in skin biopsy tissue from children with juvenile LS compared to pediatric healthy controls, with identification of significant molecular targets using RNA sequencing (RNA-Seq). In this study, differentially expressed genes (DEGs) were assessed for correlations with histopathologic and clinical features in children with juvenile LS, and were used to group the children into distinct genetic clusters based on immunophenotype. METHODS RNA-Seq was performed on sections of paraffin-embedded skin tissue obtained from 28 children with juvenile LS and 10 pediatric healthy controls. RNA-Seq was carried out using an Illumina HTS TruSeq RNA Access library prep kit, with data aligned using STAR and data analysis using a DESeq2 platform. A standardized histologic scoring system was used to score skin sections for the severity of inflammation and levels of collagen deposition. Histologic scoring was completed by 2 pathologists who were blinded with regard to the status of each sample. Spearman's rank correlation coefficients were used to assess significant correlations between DEG expression profiles and skin histologic findings in patients with juvenile LS. RESULTS We identified 589 significant DEGs in children with juvenile LS as compared to healthy controls. Hierarchical clustering was used to demonstrate 3 distinct juvenile LS immunophenotype clusters. The histologic scores of skin inflammation (based on numbers and categories of inflammatory cell infiltrates) were significantly correlated with the expression levels of HLA-DPB1, HLA-DQA2, HLA-DRA, and STAT1 genes (rs > 0.5, P < 0.01). Collagen thickness correlated with the expression levels of collagen organization genes as well as with genes found to be correlated with the severity of inflammation, including genes for major histocompatibility complex (MHC) class I, MHC class II, and interferon-γ signaling. CONCLUSION Among children with juvenile LS, 3 distinct genetic signatures, or clusters, were identified. In one cluster, inflammation-related pathways were up-regulated, corresponding to the histologic skin inflammation score. In the second cluster, fibrosis-related pathways were up-regulated. In the third cluster, gene expression in the skin corresponded to the patterns seen in healthy controls. Up-regulation of HLA class II genes was observed within the first cluster (characterized by predominant inflammation), a feature that has also been observed in the peripheral blood of patients with morphea and in the skin of patients with systemic sclerosis.
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Affiliation(s)
- Christina Schutt
- University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, and University of Rochester MedicalCenter and Golisano Children's Hospital, Rochester, New York
| | | | - Claudia Salgado
- University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Miguel Reyes-Mugica
- University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Xinjun Wang
- University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Wei Chen
- University of Pittsburgh, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lorelei Grunwaldt
- University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Kathryn S Torok
- University of Pittsburgh, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
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Mititelu R, Ridha Z, Ouchene L, Netchiporouk E. Adult-onset en coup de sabre scleroderma in a patient with linear localized scleroderma profunda: A case report and literature review. SAGE Open Med Case Rep 2021; 9:2050313X21993304. [PMID: 33796311 PMCID: PMC7983232 DOI: 10.1177/2050313x21993304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The en coup de sabre variant of linear scleroderma typically occurs in children.
We report a unique case of adult-onset en coup de sabre scleroderma in a patient
with linear localized scleroderma profunda. The patient was treated with oral
steroids and oral methotrexate improving her cutaneous disease. This case
highlights the importance of a thorough cutaneous examination as this adult
patient developed an entity traditionally believed to occur in childhood.
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Affiliation(s)
- Roxana Mititelu
- Division of Dermatology, McGill University Health Centre, Montreal, QC, Canada
| | - Zainab Ridha
- Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Lydia Ouchene
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Elena Netchiporouk
- Division of Dermatology, McGill University Health Centre, Montreal, QC, Canada
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Abstract
ABSTRACT Morphea is an autoimmune skin disease with protean clinical manifestations. Histologic features are similarly variable, and skin biopsies may be nondiagnostic. A single-institution retrospective cohort study was conducted. Morphea patients who had a biopsy in 2005-2015 were included, and a histopathological review was conducted by 2 pathologists. There were 51 biopsy specimens from 40 subjects. The most common histologic features were dermal sclerosis (90%), dermal thickening (78%), collagen homogenization (86%), a superficial and deep infiltrate (76%), a moderate-abundant inflammatory infiltrate (73%), and periadnexal fat loss/decreased skin appendages (71%). Twenty-four specimens were not diagnostic of morphea. In these specimens, the main clues to diagnosis included the presence of dermal sclerosis (79%), subtle collagen homogenization (75%), dermal thickening (58%), moderate-to-abundant plasma cells (50%), and perineural inflammation (50%). There were no statistically significant differences between active and inactive lesions, nor untreated and treated lesions. The histopathologic features of morphea are variable and a high proportion of biopsies are not diagnostic. Clinicians and pathologists should have a high degree of suspicion to correctly make the diagnosis of morphea.
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Abstract
Alopecia is a skin condition of great social and psychologic impact. Primary alopecia originates from the hair follicles and usually does not have systemic manifestations; however, secondary alopecia can affect the hair follicles in the setting of systemic diseases, medications, and external trauma. Connective tissue diseases, granulomatous diseases, bullous diseases, infections, and tumors are some of the systemic diseases that will be covered in this review. Trichoscopy is a useful noninvasive tool that can help with the diagnosis in the office and can guide the selection of the optimal site for the scalp biopsy. Histopathology is the ultimate tool for the diagnosis in most cases of secondary alopecia and can be performed on vertical and horizontal sections. In most cases, treating the underlying condition is the single most important strategy, but topical treatments for the alopecia are also applied.
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Affiliation(s)
- Sonali Nanda
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Valeria De Bedout
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mariya Miteva
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
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Sonthalia S, Agrawal M, Sharma P, Goldust M. Linear Patch of Alopecia in a Child: Trichoscopy Reveals the Actual Diagnosis. Skin Appendage Disord 2019; 5:409-412. [PMID: 31799275 DOI: 10.1159/000500096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 04/01/2019] [Indexed: 02/01/2023] Open
Abstract
Linear scleroderma en coup de sabre (LSCS) is a clinical variant of morphea that presents with a linear alopecic patch over the frontal scalp. Linear alopecia areata may present as a close differential in the incipient stages of LSCS in the pediatric population, especially when the binding down and pigmentary changes characteristic of LSCS have not developed. Histopathology may also be noncontributory in such scenarios. We hereby report a case of linear alopecia in a 5-year-old Indian girl and highlight the role of trichoscopic evaluation in clinching the diagnosis. This emphasizes the importance of clinicodermoscopic-pathological correlation over clinicopathological correlation for cutaneous diagnosis.
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Affiliation(s)
| | - Mahima Agrawal
- Department of Dermatology and STD, LHMC-SK Hospital, New Delhi, India
| | - Poonam Sharma
- Department of Dermatology and STD, Skin Institute and School of Dermatology, New Delhi, India
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11
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Asano Y, Takahashi T, Saigusa R. Systemic sclerosis: Is the epithelium a missing piece of the pathogenic puzzle? J Dermatol Sci 2019; 94:259-265. [DOI: 10.1016/j.jdermsci.2019.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 04/26/2019] [Indexed: 10/26/2022]
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12
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Abdalla BMZ, Matsunaga N, Landman G, Machado Filho CD, Criado PR. Association between frontal fibrosing alopecia and linear scleroderma "coup de sabre". Australas J Dermatol 2019; 60:e256-e258. [PMID: 30613936 DOI: 10.1111/ajd.12979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Progranulin overproduction due to constitutively activated c-Abl/PKC-δ/Fli1 pathway contributes to the resistance of dermal fibroblasts to the anti-fibrotic effect of tumor necrosis factor-α in localized scleroderma. J Dermatol Sci 2018; 92:207-214. [DOI: 10.1016/j.jdermsci.2018.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/02/2018] [Accepted: 09/11/2018] [Indexed: 11/21/2022]
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Asano Y, Fujimoto M, Ishikawa O, Sato S, Jinnin M, Takehara K, Hasegawa M, Yamamoto T, Ihn H. Diagnostic criteria, severity classification and guidelines of localized scleroderma. J Dermatol 2018; 45:755-780. [PMID: 29687475 DOI: 10.1111/1346-8138.14161] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/06/2017] [Indexed: 11/26/2022]
Abstract
We established diagnostic criteria and severity classification of localized scleroderma because there is no established diagnostic criteria or widely accepted severity classification of the disease. Also, there has been no clinical guideline for localized scleroderma, so we established its clinical guideline ahead of all over the world. In particular, the clinical guideline was established by clinical questions based on evidence-based medicine according to the New Minds Clinical Practice Guideline Creation Manual (version 1.0). We aimed to make the guideline easy to use and reliable based on the newest evidence, and to present guidance as specific as possible for various clinical problems in treatment of localized scleroderma.
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Affiliation(s)
- Yoshihide Asano
- Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Osamu Ishikawa
- Department of Dermatology, Graduate School of Medicine, Gunma University, Gunma, Japan
| | - Shinichi Sato
- Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masatoshi Jinnin
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kazuhiko Takehara
- Department of Molecular Pathology of Skin, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Minoru Hasegawa
- Department of Dermatology, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Toshiyuki Yamamoto
- Department of Dermatology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Systemic sclerosis complicated with localized scleroderma-like lesions induced by Köbner phenomenon. J Dermatol Sci 2018; 89:282-289. [DOI: 10.1016/j.jdermsci.2017.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/19/2017] [Accepted: 12/11/2017] [Indexed: 01/09/2023]
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Rattanakaemakorn P, Jorizzo JL. The efficacy of methotrexate in the treatment of en coup de sabre (linear morphea subtype). J DERMATOL TREAT 2017; 29:197-199. [DOI: 10.1080/09546634.2017.1341615] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ploysyne Rattanakaemakorn
- Division of Dermatology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok, Thailand
- Department of Dermatology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Joseph L. Jorizzo
- Department of Dermatology, Wake Forest School of Medicine, Winston Salem, NC, USA
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17
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Sawamura S, Jinnin M, Shimbara M, Nakamura K, Kudo H, Inoue K, Nakayama W, Kajihara I, Fukushima S, Ihn H. Serum levels of genomic DNA of α1(I) collagen are elevated in scleroderma patients. J Dermatol 2017; 44:927-931. [PMID: 28370352 DOI: 10.1111/1346-8138.13838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 02/13/2017] [Indexed: 11/29/2022]
Abstract
Recent studies have indicated that various nucleic acids are present in human sera, and attracted attention for their potential as novel disease markers in many human diseases. In this study, we tried to evaluate the possibility that DNA and RNA of collagens exist in human sera, and determined whether their serum levels can be useful biomarkers in scleroderma patients. The RNA or DNA of collagens were purified from sera, and detected by polymerase chain reaction or quantitated by real-time polymerase chain reaction. Among approximately 18 360 bases of full-length α1(I) collagen DNA, various regions were detected by polymerase chain reaction in human sera. However, α2(I) collagen DNA, α1(I) collagen RNA or α2(I) collagen RNA were not detectable. α1(I) Collagen DNA in sera was quantitative using our method. The levels of serum α1(I) collagen DNA were significantly increased in scleroderma patients compared with healthy control subjects or systemic lupus erythematosus patients. According to the receiver-operator curve analysis, serum α1(I) collagen DNA levels were shown to be effective as a diagnostic marker of scleroderma. Furthermore, when we determined the association of serum α1(I) collagen DNA levels with clinical/laboratory features in scleroderma patients, those with elevated α1(I) collagen DNA levels showed significantly higher prevalence of pitting scars/ulcers. In summary, elevation of serum α1(I) collagen DNA levels in scleroderma patients may be useful as the diagnostic marker, reflecting the presence of vasculopathy.
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Affiliation(s)
- Soichiro Sawamura
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masatoshi Jinnin
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Miki Shimbara
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kayo Nakamura
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hideo Kudo
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kuniko Inoue
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Wakana Nakayama
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Ikko Kajihara
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Satoshi Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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18
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Niklander S, Marín C, Martínez R, Esguep A. Morphea "en coup de sabre": An unusual oral presentation. J Clin Exp Dent 2017; 9:e315-e318. [PMID: 28210455 PMCID: PMC5303337 DOI: 10.4317/jced.53151] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 07/06/2016] [Indexed: 01/15/2023] Open
Abstract
Morphea, or localized scleroderma, is an inflammatory disease that leads to sclerosis of the skin and underlying tissues due to excessive collagen deposition. Oral involvement is unusual and it may produce white linear fibrotic areas with a scar-like appearance, atrophy of tongue papillae, gingival recession and alveolar bone resorption. We report a case of a 13-year-old girl who consulted for progressive recession on the attached gingiva of her upper left incisors. She also presented a hypopigmented line on the left side skin of her upper lip, which continued through the vermilion and the lip mucosa, including the gingiva of the affected teeth. Clinical examination, blood tests, computerized axial tomography, echo-Doppler ultrasound and histopathological evaluation confirmed the diagnosis of morphea. Treatment with methotrexate and systemic corticosteroids was conducted. After 24 months, no other lesions appeared. No adverse side effects have been reported so far.
Key words:Localized scleroderma, oral morphea, linear scleroderma, oral involvement, intraoral lesions.
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Affiliation(s)
- Sven Niklander
- DDS, MDent, MSc, Department of Oral Medicine and Oral Pathology, Universidad Andres Bello, Viña del Mar, Chile. Avenida Valparaíso 1560, Viña del Mar, Chile
| | - Constanza Marín
- DDS, Department of Oral Medicine and Oral Pathology, Universidad Andres Bello, Viña del Mar, Chile. Avenida Valparaíso 1560, Viña del Mar, Chile
| | - René Martínez
- DDS, MSc, Department of Oral Medicine and Oral Pathology, Universidad Andres Bello, Viña del Mar, Chile. Avenida Valparaíso 1560, Viña del Mar, Chile
| | - Alfredo Esguep
- DDS, MSc, Department of Oral Medicine and Oral Pathology, Universidad Andres Bello, Viña del Mar, Chile. Avenida Valparaíso 1560, Viña del Mar, Chile
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Nakamura K, Yoshizaki A, Saigusa R, Taniguchi T, Asano Y, Sato S. The efficacy of dantrolene sodium for muscle cramps in patients with localized scleroderma. J Eur Acad Dermatol Venereol 2016; 30:e188-e189. [DOI: 10.1111/jdv.13497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K. Nakamura
- Department of Dermatology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - A. Yoshizaki
- Department of Dermatology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - R. Saigusa
- Department of Dermatology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - T. Taniguchi
- Department of Dermatology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Y. Asano
- Department of Dermatology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - S. Sato
- Department of Dermatology; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
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Muñoz Garza FZ, Manubens Mercadè E, Roè Crespo E, Puig Sanz L, Baselga Torres E. Linear Morphea Mimicking Lichen Striatus in Its Early Presentation. Pediatr Dermatol 2016; 33:e23-6. [PMID: 26647352 DOI: 10.1111/pde.12722] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Linear morphea and lichen striatus are distinct conditions that have been linked in only one previous case report. We describe two patients with facial lichen striatus preceding linear morphea at the same site. A possible pathogenic relationship is discussed.
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Affiliation(s)
| | | | - Esther Roè Crespo
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lluis Puig Sanz
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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21
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Takahashi T, Asano Y, Oka T, Miyagaki T, Tamaki Z, Nonaka S, Sato S. Scleroderma en coup de sabre with recurrent episodes of brain hemorrhage. J Dermatol 2015; 43:203-6. [DOI: 10.1111/1346-8138.13023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 06/03/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Takehiro Takahashi
- Department of Dermatology; University of Tokyo Graduate School of Medicine; Tokyo Japan
| | - Yoshihide Asano
- Department of Dermatology; University of Tokyo Graduate School of Medicine; Tokyo Japan
| | - Tomonori Oka
- Department of Dermatology; University of Tokyo Graduate School of Medicine; Tokyo Japan
| | - Tomomitsu Miyagaki
- Department of Dermatology; University of Tokyo Graduate School of Medicine; Tokyo Japan
| | - Zenshiro Tamaki
- Department of Dermatology; University of Tokyo Graduate School of Medicine; Tokyo Japan
| | - Senshu Nonaka
- Department of Neurosurgery; Juntendo University Urayasu Hospital; Chiba Japan
| | - Shinichi Sato
- Department of Dermatology; University of Tokyo Graduate School of Medicine; Tokyo Japan
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