Long-term methotrexate efficacy in juvenile localized scleroderma

Methods We prospectively followed a cohort of patients with JLS who were enrolled in a double-blind, randomized controlled trial. Oral MTX was used at a dose of 15 mg/m once a week (max 20 mg) for at lest 24 months; prednisone (1 mg/Kg/day, max 50 mg), in a single morning dose for 3 months was added. A target lesion was evaluated clinically, with infrared thermography and using a computerized scoring system with skin score rate (SSR) evaluation. Response to treatment was defined as: no new lesions; SSR<1; decrease lesion temperature by at least 10% compared to baseline. Treatment failure was defined by new lesions, SSR>1, or increased lesion temperature. Partial Remission (PR) was defined when the state of responder was maintained ON treatment for at least 6 months, complete remission (CR) the state of responder OFF treatment for at least 6 months.