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The fasciitis-morphea complex in children
1Lucille Salter Packard Children's Hospital, Stanford, Palo Alto, CA 94304.
Insights
Fasciitis and morphea are linked childhood conditions. Steroids help fasciitis, while penicillamine may improve morphea sclerosis but not new lesions.
Area of Science:
- Pediatric Rheumatology
- Dermatology
- Pediatric Autoimmune Diseases
Background:
- This study investigates the combined syndrome of fasciitis and morphea in children.
- Understanding this rare co-occurrence is crucial for accurate diagnosis and management.
Observation:
- Six children with fasciitis symptoms were evaluated.
- Morphea symptoms manifested from 1 year prior to 4 years after fasciitis onset.
- Fasciitis presented with symmetrical swelling, pain, and contractures; morphea and fasciitis affected different body areas.
Findings:
- Fasciitis and morphea are interconnected clinical manifestations in pediatric patients.
- Corticosteroid therapy demonstrated efficacy in treating the fasciitis component.
- Penicillamine showed potential in ameliorating morphea-related sclerosis, though it did not prevent new lesion development.
Implications:
- Early recognition of this combined syndrome is vital for effective treatment strategies.
- Tailored therapeutic approaches are necessary, considering the differential response of fasciitis and morphea to treatments.
- Further research is warranted to explore the underlying mechanisms and optimize management for children with coexisting fasciitis and morphea.
Objective:
To describe the clinical presentation and treatment of the combined syndrome of fasciitis and morphea in children.
Setting:
The rheumatic disease clinic of a university children's hospital.
Patients:
Six children who were referred for signs or symptoms of fasciitis were observed.
Selection Procedures:
All children who were referred for fasciitis were included in the study.
Interventions:
Therapy included prednisone initially and subsequent long-term treatment with penicillamine and alternate-day doses of prednisone.
Measurements And Results:
Symptoms of morphea appeared 1 year before to 4 years after the first signs of fasciitis were observed. The fasciitis was characterized by usually symmetrical, centrifugal swelling, pain, and contracture formation. The morphea and fasciitis did not appear in the same areas of the body.
Conclusions:
The fasciitis and morphea are clearly linked manifestations. The fasciitis, but not the morphea, appears to respond to treatment with steroids. Treatment with penicillamine may ameliorate the sclerosis of the morphea but does not stop new lesions from appearing.
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