Juvenile localized scleroderma: Is it a benign disease?

Introduction: Juvenile localized scleroderma is a polymorphic disease. It is more prevalent in girls and has a significant morbidity. Extra-cutaneous involvement is common, and polyautoimmunity can reach 7%. The clinical characteristics of this disease in Colombian patients are currently unknown. Objective: To describe the clinical characteristics, morbidity and outcomes in patients with juvenile localized scleroderma in different pediatric rheumatology clinics in Colombia. Materials and methods: A descriptive, retrospective, and multicentre study was conducted on patients with juvenile localized scleroderma with a minimum of 1 year of disease onset, and 6 months of follow-up in 10 pediatric rheumatology clinics. Results: The study included 88 patients, with a gender distribution of female 2.1: male 1. Mean age at disease onset was 7.1 years (0–14). Mean disease duration at diagnosis was 16.5 months (1–96). Sub-type distribution was, circumscribed (32.9%), mixed (31.8%), and linear (21.5%), that increased to 55% if linear lesions of the mixed subtype are included), generalized (11.4%), and pan-sclerotic morphea (2.3%). Esthetic compromise was detected in 91%, with growth disturbances in 41%, and joint functional compromise in 32%. Extracutaneous involvement occurred in 22.7% and polyautoimmunity in 12.5%. Conclusions: Juvenile localized scleroderma is a polymorphic and unpredictable disease. It diagnosed late in most of the cases. Extra-cutaneous involvement suggests that is not a disease limited to skin. An early diagnosis, a dynamic treatment and a close follow-up helps to prevent, and detect, complications arising from the disease. © 2017 Asociación Colombiana de Reumatologı́a. Published by Elsevier España, S.L.U. All