علاج التصلب الجلدي الخطي لدى الأطفال (دون 18 عامًا) مع إصابة شديدة في الجلد أو الجهاز العضلي الهيكلي

References

DOI: 10.1111/ddg.15328

• While the limited type of LoS (morphea) primarily occurs in adults, linear types are more prevalent in childhood.
• However, in all other cases and for active linear LoS in childhood, potent systemic therapy should be initiated as early as possible to prevent potential late complications (contractures, growth disturbances, limb deformities, etc.).
• We recommend methotrexate (MTX) (off-label) as the first-line systemic therapy for LoS with severe skin and/or musculoskeletal involvement.
• We suggest considering systemic glucocorticosteroid therapy in addition to the systemic treatment with MTX during the active phase of LoS.
• We recommend physical therapy and manual therapy in all subtypes of LoS with restricted mobility (for example joint contracture, muscle imbalance [atrophy/hypotrophy]) and for the prevention of joint contracture in cases of skin involvement spanning the joint.
• When assessing the effectiveness of the chosen therapeutic concept, it should be noted that the reduction of sclerosis typically takes at least 8 to 12 weeks in most cases.