Clinical and Laboratory ObservationsChildren with morphea have normal self-perception☆
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).Variable All subjects Generalized morphea Plaque morphea LM Limb LM Face No. of patients 47 12 9 12 14 Mean age (y) 11.7 12.8 12 12.9 9.6 Female 25 6 4 8 7 Male 22 6 5 4 7 Time since onset (y)* 4.5 4.9 4.7 4.7 3.7 Quality of health (VAS, maximum score = 10)* 8.2 8.2 8.6 7 8.9 Quality of life (VAS, maximum score = 10)* 7.9 8 8 7.4 8.4 *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
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Cited by (21)
Localized Scleroderma
2015, Textbook of Pediatric RheumatologyCorrelates of self-reported quality of life in adults and children with morphea
2014, Journal of the American Academy of DermatologyCitation Excerpt :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.
Pediatric Systemic Lupus Erythematosus, Dermatomyositis, Scleroderma, and Vasculitis
2012, Kelley's Textbook of Rheumatology: Volume 1-2, Ninth EditionLocalized sclerodermas
2011, Textbook of Pediatric RheumatologyScleroderma in children and adolescents
2002, Rheumatic Disease Clinics of North AmericaSystematic Review of Health-Related Quality of Life Impact in Juvenile Localized Scleroderma
2024, Arthritis Care and Research
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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.