Skin trauma may play a role in the development of morphea lesions. The association between trauma and the distribution of cutaneous lesions has never been examined to our knowledge.
We sought to determine whether patients enrolled in the Morphea in Adults and Children (MAC) cohort exhibit skin lesions distributed in areas of prior (isotopic) or ongoing (isomorphic) trauma.
This was a cross-sectional analysis of the MAC cohort.
Of 329 patients in the MAC cohort, 52 (16%) had trauma-associated lesions at the onset of disease. Patients with lesions in an isotopic distribution had greater clinical severity as measured by a clinical outcome measure (mean modified Rodnan Skin Score of 13.8 vs 5.3, P = .004, 95% confidence interval 3.08-13.92) and impact on life quality (mean Dermatology Life Quality Index score 8.4 vs 4.1, P = .009, 95% confidence interval 1.18-7.50) than those with an isomorphic distribution. Most frequent associated traumas were chronic friction (isomorphic) and surgery/isotopic.
Recall bias for patient-reported events is a limitation.
Of patients in the MAC cohort, 16% developed initial morphea lesions at sites of skin trauma. If these findings can be confirmed in additional series, they suggest that elective procedures and excessive skin trauma or friction might be avoided in these patients.Le texte complet de cet article est disponible en PDF.
Key words : Dermatology Life Quality Index, localized scleroderma, modified Rodnan Skin Score, morphea, Morphea in Adults and Children cohort, skin trauma
Abbreviations used : DLQI, GVHD, MAC, mRSS, QOL
| Research for this manuscript was supported in part by National Institutes of Health (NIH) Grant No. K23AR056303-4. This work was conducted with support from UT-STAR, NIH/National Center for Research Resources (NCRR)/National Center for Advancing Translational Sciences Grant No. UL1RR024982. The content is solely the responsibility of the authors and does not necessarily represent the official views of UT-STAR, University of Texas Southwestern Medical Center at Dallas and its affiliated academic and health care centers, the NCRR, or the NIH.
| Conflicts of interest: None declared.
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