Elsevier

The Journal of Pediatrics

Volume 137, Issue 5, November 2000, Pages 727-730
The Journal of Pediatrics

Clinical and Laboratory Observations
Children with morphea have normal self-perception

https://doi.org/10.1067/mpd.2000.108564Get rights and content

Abstract

We evaluated the self-esteem and quality of life of 47 children with morphea with the use of the Harter self-perception profile for children and Visual Analog Scale. Most children with morphea have normal self-worth and a high quality of life. Morphea, like some other childhood chronic illnesses, does not impair self-esteem. (J Pediatr 2000;137:727-30)

Section snippets

Patients

We studied 47 consecutive patients attending the morphea clinic at The Hospital for Sick Children. At the time of the study, morphea had been diagnosed in 66 children at the clinic. The patients were grouped by disease subtype: (1) plaque morphea, (2) generalized morphea (3 or more lesions or a combination of a linear band on a limb with another lesion), (3) LM, occurring on a limb, or (4) LM occurring on the face (en coup de sabre). Patients with Parry-Romberg syndrome were included in the

Results

The mean time from disease onset was 4.4 years (range 0.5 to 13.8 years). On average, QoL and health was high (Table I).

. Patient characteristics and mean severity and Visual Analog Scale scores

VariableAll subjectsGeneralized morpheaPlaque morpheaLM LimbLM Face
No. of patients471291214
Mean age (y)11.712.81212.99.6
Female256487
Male226547
Time since onset (y)*4.54.94.74.73.7
Quality of health (VAS, maximum score = 10)*8.28.28.678.9
Quality of life (VAS, maximum score = 10)*7.9887.48.4
*Figures shown are

Discussion

Despite the potentially disfiguring effects of morphea, our subjects as a group had normal self-perception. This finding runs contrary to our hypothesis that morphea would result in a lower self-esteem.

We had thought that physical appearance would be the most vulnerable domain in morphea. However, our patients’ scores in this domain were normal. Only 1 patient had a very poor score that could not be explained by the disease, which was mild. Our patients with facial lesions were no more likely

References (14)

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    Further, damage from morphea (pigmentary alteration, dermal or subcutaneous atrophy, and central sclerosis) may impair QOL even without functional deficits, thus indicating the need to improve support and therapy offered to patients with inactive morphea. Patient-perceived disease impact (DLQI) has not previously been compared with physician-based measures in adults, and only limited studies exist in children.11 In this study, mRSS, LoSSI, and LoSDI correlated with DLQI but not CDLQI, suggesting the validity of DLQI in capturing aspects of morphea important to adults but not necessarily children.

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Reprint requests: B.M. Feldman, Department of Paediatics, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8.

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