{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T19:10:51Z","timestamp":1771355451925,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2007,2,1]],"date-time":"2007-02-01T00:00:00Z","timestamp":1170288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2007,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background\u2002<\/jats:bold> Treatment of scleroderma is difficult and currently no treatment can induce complete remission of the disease.<\/jats:p><jats:p><jats:bold>Objective\u2002<\/jats:bold> To evaluate weekly oral methotrexate in the treatment of Indian patients with systemic sclerosis.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Thirty\u2010three patients with systemic sclerosis presenting to the department of dermatology (outpatients) who satisfied the inclusion criteria were enrolled into the study. All cases were admitted into the dermatology ward for detailed evaluation. A detailed history and physical examination, including assessment of disease severity by Rodnan skin scoring, was carried out. Baseline investigations included complete blood counts, blood glucose, serum electrolytes, renal function test, liver function tests, urine examination (albumin, sugar, microscopic examination, 24\u2010h protein), ANA, chest X\u2010ray, Barium swallow, pulmonary function test, electrocardiogram (ECG), HRCT of chest, and 4\u2010mm punch skin biopsy from dorsum of the hand. All the patients were treated with oral methotrexate (15\u00a0mg\/week) for 6\u00a0months, following standard guidelines.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> The patients included 29\u00a0(87.9%)\u00a0females and four\u00a0(12.1%)\u00a0males with a mean age of 31.45\u00a0\u00b1\u00a08.76\u00a0years. The mean duration of disease was 5.6\u00a0\u00b1\u00a04.5\u00a0years (range 2\u00a0months to 15\u00a0years). All the patients had binding down of skin, 31\u00a0(93.9%) had Raynaud's phenomenon, 31\u00a0(93.9%) had pigmentary change, 21\u00a0(63.6%) had hand contractures, 17\u00a0(51.5%) had fingertip ulcers, 15\u00a0(45.5%) had dyspnoea, 14\u00a0(42.4%) had restricted mouth opening, 13\u00a0(39.4%) had telangiectasia, 11\u00a0(33.3%) had fingertip resorption, eight\u00a0(24.2%) had joint complaints, six (18.2%) had dysphagia, and one\u00a0(3.03%) had gangrene. On laboratory investigation ANA was positive in 29\u00a0(87.9%)\u00a0patients, dsDNA was raised in only four\u00a0(12.1%), baseline chest X\u2010ray was abnormal in 18\u00a0(54.5%), HRCT was abnormal in 27\u00a0(81.8%), abnormal PFT in 32\u00a0(96.9%), abnormal ECG in five\u00a0(15.2%), and barium swallow abnormality in 19\u00a0(57.5%)\u00a0patients.<\/jats:p><jats:p>Twenty\u2010five patients completed the 6\u2010month follow up. There was subjective improvement in binding down\u00a0(80%), Raynaud's phenomenon\u00a0(96%), fingertip ulceration\u00a0(88.8%), hyperpigmentation\u00a0(77.2%) and dyspnoea\u00a0(45.5%). The objective parameters showed statistically significant improvement in mouth openingm, but improvement of skin score, lung function (chest radiograph, PFT, HRCT), and dysphagia was not significant at the 6\u2010month follow up. In eight patients, treatment was continued for 1\u00a0year of methotrexate, which showed statistically significant improvement in skin score.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> It was concluded that methotrexate for 6\u00a0months only provides subjective improvement, and further studies after 1\u00a0year of treatment with methotrexate are recommended.<\/jats:p>","DOI":"10.1111\/j.1365-4632.2007.02887.x","type":"journal-article","created":{"date-parts":[[2010,8,12]],"date-time":"2010-08-12T16:13:04Z","timestamp":1281629584000},"page":"218-223","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Evaluation of oral methotrexate in the treatment of systemic sclerosis"],"prefix":"10.1111","volume":"46","author":[{"given":"M.","family":"Krishna Sumanth","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinod K.","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binod K.","family":"Khaitan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anu","family":"Kapoor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trilokraj","family":"Tejasvi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,2]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"1217","volume-title":"Oxford Text Book of Rheumatology","author":"Black CM"},{"key":"e_1_2_5_3_2","first-page":"40","article-title":"Reversal of systemic sclerosis with dexamethasone pulse therapy in progressive systemic sclerosis","volume":"56","author":"Pasricha JS","year":"1990","journal-title":"Ind J Dermatol Venereol Leprol"},{"key":"e_1_2_5_4_2","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S0889-857X(21)01050-4","article-title":"Treatment of generalized systemic sclerosis","volume":"16","author":"Torres MA","year":"1990","journal-title":"Rheum Dis Clin North Am"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780370518"},{"key":"e_1_2_5_6_2","first-page":"573","article-title":"Intravenous cyclophosphamide therapy for systemic sclerosis. A single\u2010center experience and review of the literature with pooled analysis of lung function test results","volume":"22","author":"Airo P","year":"2004","journal-title":"Clin Exp Rheumato"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/35.4.364"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780230510"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-74-5-714"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1085-5629(98)80058-8"},{"key":"e_1_2_5_11_2","first-page":"254","article-title":"Progressive systemic sclerosis in south India","volume":"39","author":"Krishnamurthy V","year":"1991","journal-title":"J Assoc Phys Ind"},{"key":"e_1_2_5_12_2","first-page":"765","article-title":"Clinical and laboratory profile of systemic sclerosis in north India","volume":"38","author":"Kumar A","year":"1990","journal-title":"J Asso Phys Ind"},{"key":"e_1_2_5_13_2","first-page":"395","article-title":"Connective tissue diseases in India. III clinical and immunological profile of progressive systemic sclerosis","volume":"27","author":"Malaviya AN","year":"1979","journal-title":"J Asso Phys Ind"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1961.01580150005001"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400421"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.176.3.2389033"},{"key":"e_1_2_5_17_2","first-page":"1520","article-title":"High resolution computed tomography in early scleroderma lung disease","volume":"18","author":"Warrick JH","year":"1991","journal-title":"J Rheumatol"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/1096-9896(2000)9999:9999<::AID-PATH779>3.0.CO;2-8"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200106)44:6<1351::AID-ART227>3.0.CO;2-I"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-4632.2007.02887.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-4632.2007.02887.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T23:19:03Z","timestamp":1696893543000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-4632.2007.02887.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,2]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2007,2]]}},"alternative-id":["10.1111\/j.1365-4632.2007.02887.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-4632.2007.02887.x","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,2]]},"assertion":[{"value":"2007-02-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}