{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:35:38Z","timestamp":1789961738291,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,3,27]],"date-time":"2020-03-27T00:00:00Z","timestamp":1585267200000},"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":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Paediatric localized scleroderma is a severe inflammatory disorder associated with tissue atrophy, often leading to disability. Assessing disease activity and response to treatment has always been challenging and remains an important difficulty in clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate prospectively the efficacy of systemic treatment with corticosteroids and methotrexate in children with localized scleroderma and the validity of infrared thermography, laser Doppler flowmetry and high\u2010frequency ultrasound in assessing disease activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children with localized scleroderma were prospectively treated with corticosteroids (initially pulsed <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> methylprednisolone 30\u00a0mg\/kg\/day, maximum 500\u00a0mg\/day and\/or oral prednisolone 0.5\u20131\u00a0mg\/kg\/day) and methotrexate (15\u00a0mg\/m<jats:sup>2<\/jats:sup> weekly). Treatment response was evaluated using a clinical activity score. Skin temperature, blood flow, dermal thickness and dermal echogenicity of clinically active skin lesions were determined in relation to the unaffected contralateral site at baseline and after 3, 6, 12 and 18\u00a0months. Patient charts were later reviewed for long\u2010term follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two patients were included [age 6.0 (0.2\u201314.4] years; female\u2010to\u2010male ratio 3.4\u00a0:\u00a01) All responded well to therapy. Disease reversibility was demonstrated in the majority of children with partial resolution of skin sclerosis and regrowth of hair. Laser Doppler flowmetry and high\u2010frequency ultrasound findings correlated with disease activity at baseline. Thermography had no added value in this cohort. The recurrence rate was 36% in the follow\u2010up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Corticosteroids and methotrexate are highly effective as first\u2010line therapy in paediatric localized scleroderma, leading to partial reversal of skin manifestations. However, the recurrence rate is substantial and affected children require long\u2010term follow\u2010up. Laser Doppler flowmetry and high\u2010frequency ultrasound correlate with disease activity in the acute phase and may assist decision\u2010making in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.16308","type":"journal-article","created":{"date-parts":[[2020,2,21]],"date-time":"2020-02-21T06:36:50Z","timestamp":1582267010000},"page":"1609-1616","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Prospective evaluation of treatment response and disease reversibility of paediatric localized scleroderma (morphoea) to steroids and methotrexate using multi\u2010modal imaging"],"prefix":"10.1111","volume":"34","author":[{"given":"L.","family":"Weibel","sequence":"first","affiliation":[{"name":"Department of Dermatology Pediatric Skin Center University Children's Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7160-3958","authenticated-orcid":false,"given":"M.","family":"Theiler","sequence":"additional","affiliation":[{"name":"Department of Dermatology Pediatric Skin Center University Children's Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.J.","family":"Howell","sequence":"additional","affiliation":[{"name":"Microvascular Diagnostics Royal Free Hospital Institute of Immunity and Transplantation London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.P.","family":"Denton","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology and Connective Tissue Disease UCL Division of Medicine Royal Free London NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Waelchli","sequence":"additional","affiliation":[{"name":"Department of Dermatology Pediatric Skin Center University Children's Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Atherton","sequence":"additional","affiliation":[{"name":"Department of Dermatology Great Ormond Street Hospital for Children London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Woo","sequence":"additional","affiliation":[{"name":"Centre for Adolescent Rheumatology University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.I.","family":"Harper","sequence":"additional","affiliation":[{"name":"Department of Dermatology Great Ormond Street Hospital for Children London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kei251"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-018-3144-8"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2007.00948.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12758"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.05.005"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21264"},{"key":"e_1_2_6_8_1","first-page":"1175","article-title":"Development of consensus treatment plans for juvenile localized scleroderma: a roadmap toward comparative effectiveness studies in juvenile localized scleroderma","volume":"64","author":"Li SC","year":"2012","journal-title":"Arthritis Care 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