Physical therapy is very
important for patients prone to develop joint and muscle
contractures and deformities. Joint mobility should be
Hadi Nick, Romania:
1.serologic test for Borrelia B. => + => tx. For B.B.
3.Corticosteroids, penicillamine, methotrexate,
calcipotriene, calcitriol, cyclosporine, and UVA-1 with modest
4. Atrophic lesions also may be treated surgically with
collagen injections and autologous fat transplantation.
there is no effective treatment for this localized form of
morphea and the only important point is to examine the involvement
of deeper tissues. The disease is often self-limited; but if it is
advancing, topical and/or intralesional steroids with or without
UVA may be tried for example in this patient. So many medications
have been tried in this disease, but the results are unclear (calcitriol,
Vit.E, phenytoin, MTX, UVA therapy etc).
Akaberi, Iran, Yazd:
Therapy is plastic surgery
the treatment of localized
scleroderma(morphea) remains unsatisfactory, but because the disease is
self-limited, most cases require little or no treatment. when
is attempted is usually involves application of high-to
topical glucocorticoides to the lesions, which may be
by intra lesional injections of glucocorticoids.
Yalda Nahidi, Iran:
hemiatrophy is usually persistent and the only treatment for
facial hemiatrophy is reconstructive surgery, but frontoparietal
scleroderma may clear spontaneously, but if therapy is required we
can use topical (intralesional steroids)[ alone or in combination
with PUVA] , calcipotriol, tigasone and antimalarial agents.
systemic corticosteroids can be used in it's inflammatory stage.
Mehrdad Mehravaran, Hungary:
(Daivonex®) ointment 0.005% applied twice daily with
rapidly progressive disease, systemic steroids up to 1 mg/kg
per day, plus methotrexate 10–25 mg per week may be
effective in arresting progression of the condition.
Cyclosporine 3 mg/kg/day for a trial of 1–2 months
may be considered in patients failing the above treatments.
In patients treated with systemic steroids and
methotrexate, once the condition is controlled, the agents are
gradually tapered over months to several years.
After the linear morphea is controlled and burned out,
cosmetic procedures are indicated to replace lost dermis and
subcutaneous tissue. Fillers and fat transplantation, or excision
of affected areas with tissue expansion, if required, may be
considered. Surgery does not appear to "reactivate"
Should take care:
Linear scleroderma can result in significant permanent
sequelae. Therapy should especially be considered in younger
children that might produce permanent disfigurement. In older
children and adults therapy may be less aggressive as the
complications may be less severe. Consider the risk versus the
possible benefit before undertaking immunosuppressive therapy.
Patients with limited cutaneous disease may have
involvement of underlying tissues such as bone, brain, and lung.
Appropriate evaluations are indicated if symptoms suggest
involvement of deeper tissues.