TY - JOUR
T1 - The role of skin trauma in the distribution of morphea lesions
T2 - A cross-sectional survey of the Morphea in Adults and Children cohort IV
AU - Grabell, Daniel
AU - Hsieh, Clifford
AU - Andrew, Rachel
AU - Martires, Kathryn
AU - Kim, Andrew
AU - Vasquez, Rebecca
AU - Jacobe, Heidi
N1 - Funding Information:
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.
PY - 2014/9
Y1 - 2014/9
N2 - Background 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. Objective 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. Methods This was a cross-sectional analysis of the MAC cohort. Results 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. Limitations Recall bias for patient-reported events is a limitation. Conclusion 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.
AB - Background 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. Objective 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. Methods This was a cross-sectional analysis of the MAC cohort. Results 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. Limitations Recall bias for patient-reported events is a limitation. Conclusion 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.
KW - Dermatology Life Quality Index
KW - Morphea in Adults and Children cohort
KW - localized scleroderma
KW - modified Rodnan Skin Score
KW - morphea
KW - skin trauma
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U2 - 10.1016/j.jaad.2014.04.009
DO - 10.1016/j.jaad.2014.04.009
M3 - Article
C2 - 24880663
AN - SCOPUS:84906327466
SN - 0190-9622
VL - 71
SP - 493
EP - 498
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 3
ER -