{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T14:52:30Z","timestamp":1771512750712,"version":"3.50.1"},"reference-count":5,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T00:00:00Z","timestamp":1516838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Health Labor Sciences Research Grant from the Ministry of Health Labor and Welfare"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Localized scleroderma (LoS) involves dermal but not internal inflammation and fibrosis. Cosmetic changes often impact quality of life (<jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content>), however, impairment of activities of daily living (<jats:styled-content style=\"fixed-case\">ADL<\/jats:styled-content>) in LoS patients has not been investigated. To determine what factor(s) are associated with <jats:styled-content style=\"fixed-case\">ADL<\/jats:styled-content> in adult patients with LoS, we performed a retrospective observational study in 177 Japanese adult LoS patients using a novel LoS disability score based on Barthel's indices of <jats:styled-content style=\"fixed-case\">ADL<\/jats:styled-content>: feeding, bathing, grooming, dressing, bowels, bladder, toilet use, transfers, mobility and stairs. LoS disability scores increased in proportion to the number of affected body parts but were not correlated to age and duration of illness. The presence of leg lesions significantly impaired <jats:styled-content style=\"fixed-case\">ADL<\/jats:styled-content> of LoS patients compared with lesions on other body parts. Patients treated with systemic medications, who tended to have multiple lesions, presented higher LoS disability scores than those without systemic treatments. Our study proposes that physicians evaluate <jats:styled-content style=\"fixed-case\">ADL<\/jats:styled-content>, not only <jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content>, in LoS patients. Our findings using LoS disability scoring indicate that multiple affected body parts and leg lesions are risk factors for <jats:styled-content style=\"fixed-case\">ADL<\/jats:styled-content> impairment.<\/jats:p>","DOI":"10.1111\/1346-8138.14214","type":"journal-article","created":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T08:11:53Z","timestamp":1516867913000},"page":"431-435","source":"Crossref","is-referenced-by-count":3,"title":["Impact of a new simplified disability scoring system for adult patients with localized scleroderma"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5398-0773","authenticated-orcid":false,"given":"Naoko","family":"Okiyama","sequence":"first","affiliation":[{"name":"Department of Dermatology Faculty of Medicine University of Tsukuba Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5560-9778","authenticated-orcid":false,"given":"Yoshihide","family":"Asano","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5305-7770","authenticated-orcid":false,"given":"Yasuhito","family":"Hamaguchi","sequence":"additional","affiliation":[{"name":"Department of Molecular Pathology of Skin Faculty of Medicine Institute of Medical, Pharmaceutical and Health Science Kanazawa University Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masatoshi","family":"Jinnin","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Plastic Surgery Faculty of Life Sciences Kumamoto University Kumamoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8286-0669","authenticated-orcid":false,"given":"Sei\u2010ichiro","family":"Motegi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Graduate School of Medicine Gunma University Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruka","family":"Koizumi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3738-2682","authenticated-orcid":false,"given":"Minoru","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamu","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Dermatology Graduate School of Medicine Gunma University Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichi","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiko","family":"Takehara","sequence":"additional","affiliation":[{"name":"Department of Molecular Pathology of Skin Faculty of Medicine Institute of Medical, Pharmaceutical and Health Science Kanazawa University Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8390-2573","authenticated-orcid":false,"given":"Toshiyuki","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Dermatology Fukushima Medical University School of Medicine Fukushima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manabu","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine University of Tsukuba Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hironobu","family":"Ihn","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Plastic Surgery Faculty of Life Sciences Kumamoto University Kumamoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,25]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"650","article-title":"Localized scleroderma severity index and global assessments: a pilot study of outcome instruments","volume":"35","author":"Arkachaisri T","year":"2008","journal-title":"J 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