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Вопросы современной педиатрии

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Ювенильная локализованная склеродермия. Вопросы лечения

https://doi.org/10.15690/vsp.v19i3.2119

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Аннотация

Ювенильная локализованная склеродермия (ЮЛС) это группа заболеваний детского возраста, основное проявление которых — поражение кожи и подкожных структур, как правило, без органного вовлечения. В развитии ЮЛС выделяют активную (воспалительную) и фибротическую фазы. Терапия ЮЛС в активную фазу, когда проявления со стороны кожи носят обратимый характер, намного эффективнее. Тактика лечения определяется площадью и глубиной очагов кожного поражения, появлением и распространением новых очагов, наличием внекожных признаков болезни. Основой терапии ЮЛС служат топические и системные иммуносупрессанты. Антибиотикотерапия не показана. Для оценки эффективности терапии рекомендовано использовать клинические шкалы (LoSCAT), ультразвуковое исследование, термо- и магнитно-резонансную томографию.

Об авторах

Р. К. Раупов
Санкт-Петербургский государственный педиатрический медицинский университет
Россия
194100, Санкт-Петербург, ул. Литовская, д. 2


М. М. Костик
Санкт-Петербургский государственный педиатрический медицинский университет
Россия

Костик Михаил Михайлович, доктор медицинских наук, профессор кафедры госпитальной педиатрии

194100, Санкт-Петербург, ул. Литовская, д. 2



Список литературы

1. Кубанова А. А., Кубанов А. А., Мелехина Л. Е., Богданова Е. В. Анализ состояния заболеваемости болезнями кожи и подкожной клетчатки в Российской Федерации за период 2003– 2016 гг. //Вестник дерматологии и венерологии. — 2017. — № 6. — С. 22–33. doi: 10.25208/0042-4609-2017-93-6-22-33.

2. Laxer RM, Zulian F. Localized scleroderma. Curr Opin Rheumatol. 2006;18(6):606–613. doi: 10.1097/01.bor.0000245727.40630.c3.

3. Zulian F, Culpo R, Sperotto F, et al. (2019). Consensus-based recommendations for the management of juvenile localised scleroderma. Ann Rheum Dis. 2019;78(8):1019–1024. doi: 10.1136/annrheumdis-2018-214697.

4. Kienast A, Foeldvari I. High Prevalence of Extracutaneous Manifestations and Comorbidities in 108 Patients with Juvenile Localized Scleroderma. Ann Rheum Dis. 2015;74(Suppl 2):612. doi: 10.1136/annrheumdis-2015-eular.1675.

5. Condie D, Grabell D, Jacobe H. Morphea in Adults and Children Cohort VI: A cross-sectional comparison of outcomes between adults with pediatric-onset and adult-onset morphea. Arthritis Rheumatol. 2014;66(12):3496–3504. doi: 10.1002/art.38853.

6. Knobler R, Moinzadeh P, Hunzelmann N, et al. European Dermatology Forum S1-guideline on the diagnosis and treatment of sclerosing diseases of the skin, Part 1: localized scleroderma, systemic sclerosis and overlap syndromes. J Eur Acad Dermatol Venereol. 2017;31(9):1401–1424. doi: 10.1111/jdv.14458.

7. Torok KS, Li SC, Jacobe HM, et al. Immunopathogenesis of Pediatric Localized Scleroderma. Front Immunol. 2019;10:908. doi: 10.3389/fimmu.2019.00908.

8. Constantin T, Foeldvari I, Pain CE, et al. Development of minimum standards of care for juvenile localized scleroderma. Eur J Pediatr. 2018;177(7):961–977. doi: 10.1007/s00431-018-3144-8.

9. Li SC, Feldman BM, Higgins GC, et al. Treatment of pediatric localized scleroderma: results of a survey of North American pediatric rheumatologists. J Rheumatol. 2010:37:175–181. doi: 10.3899/jrheum.090708.

10. Prinz JC, Kutasi Z, Weisenseel P, et al. «Borrelia-associated early-onset mophea»: a particular type of scleroderma in childhood and adolescence with high titer antinuclear antibodies? Results of a cohort analysis and presentation of three cases. J Am Acad Dermatol. 2009;60(2):248–255. doi: 10.1016/j.jaad.2008.09.023.

11. Локализованная склеродермия: клинические рекомендации /Российское общество дерматовенерологов и косметологов. — 2016.

12. Weide B, Walz T, Garbe C. Is morphoea caused by Borrelia burgdorferi? A review. Br J Dermatol. 2000;142(4):636–644. doi: 10.1046/j.1365-2133.2000.03407.x.

13. Fan W, Leonardi CL, Penneys NS. Absence of Borrelia burgdorferi in patients with localized scleroderma (morphea). J Am Acad Dermatol. 1995;33(4):682–684. doi: 10.1016/0190-9622(95)91311-4.

14. Kreuter A, Krieg T, Worm M, et al. German guidelines for the diagnosis and therapy of localized scleroderma. J Dtsch Dermatol Ges. 2016;14(2):199–216. doi: 10.1111/ddg.12724.

15. National Center for Biotechnology Information. PubChem Database. Calcipotriol, CID=5288783. Available online: https://pubchem.ncbi.nlm.nih.gov/compound/Calcipotriol. Accessed on April 25, 2020).

16. Cunningham BB, Landells ID, Langman C, et al. Topical calcipotriene for morphea/linear scleroderma. J Am Acad Dermatol. 1998;39(2 Pt 1):211–215. doi: 10.1016/s0190-9622(98)70077-5.

17. Kreuter A, Gambichler T, Avermaete A, et al. Combined treatment with calcipotriol ointment and lowdose ultraviolet A1 phototherapy in childhood morphea. Pediatr Dermatol. 2001;18(3):241–245. doi: 10.1046/j.1525-1470.2001.018003241.x.

18. Zwischenberger BA, Jacobe HT. A systematic review of morphea treatments and therapeutic algorithm. J Am Acad Dermatol 65: 925–941, 2011

19. Dytoc MT, Kossintseva I, Ting PT. First case series on the use of calcipotriol-betamethasone dipropionate for morphoea. Br J Dermatol. 2007;157(3):615–618. doi: 10.1111/j.1365-2133.2007.07971.x

20. Ahluwalia A. Topical glucocorticoids and the skin — mechanisms of action: an update. Mediators Inflamm. 1998;7(3):183–193. doi: 10.1080/09629359891126.

21. Sapadin AN, Fleischmajer R. Treatment of scleroderma. Arch Dermatol. 2002;138(1):99–105. doi: 10.1001/archderm.138.1.99.

22. Fett N, Werth VP. Update on morphea: part II. Outcome measures and treatment. J Am Acad Dermatol. 2011;64:231–242; quiz 243–244. doi: 10.1016/j.jaad.2010.05.046.

23. Nghiem P, Pearson G, Langley RG. Tacrolimus and pimecrolimus: from clever prokaryotes to inhibiting calcineurin and treating atopic dermatitis. J Am Acad Dermatol. 2002;46(2):228–241. doi: 10.1067/mjd.2002.120942.

24. Kroft EB, Groeneveld TJ, Seyger MM, de Jong EM. Efficacy of topical tacrolimus 0.1% in active plaque morphea: randomized, double-blind, emollient-controlled pilot study. Am J Clin Dermatol. 2009;10(9):181–187. doi: 10.2165/00128071-200910030-00004.

25. Stefanaki C, Stefanaki K, Kontochristopoulos G, et al. Topical tacrolimus 0.1% ointment in the treatment of localized scleroderma. An open label clinical and histological study. J Dermatol. 2008;35:712–718. doi: 10.1111/j.1346-8138.2008.00552.x.

26. Mancuso G, Berdondini RM. Topical tacrolimus in the treatment of localized scleroderma. Eur J Dermatol. 2003;13(6):590–592.

27. Vidal D. Topical Imiquimod: Mechanism of Action and Clinical Applications. Mini Rev Med Chem. 2006;6(5), 499–503. doi: 10.2174/138955706776876131.

28. Dytoc M, Ting PT, Man J, et al. First case series on the use of imiquimod for morphoea. Br J Dermatol. 2005;153(4):815–820. doi: 10.1111/j.1365-2133.2005.06776.x.

29. Pope E, Doria AS, Theriault M, et al. Topical imiquimod 5% cream for pediatric plaque morphea: a prospective, multiple-baseline, open-label pilot study. Dermatology. 2011;223(4):363–369. doi: 10.1159/000335560.

30. Keyal U, Bhatta AK, Wang XL. UVA1 a promising approach for scleroderma. Am J Transl Res. 2017;9(9):4280–4287.

31. Kreuter A, Hyun J, Stucker M, et al. A randomized controlled study of lowdose UVA1, medium-dose UVA1, and narrowband UVB phototherapy in the treatment of localized scleroderma. J Am Acad Dermatol. 2006;54(3):440–447. doi: 10.1016/j.jaad.2005.11.1063.

32. Asano Y, Fujimoto M, Ishikawa O. Diagnostic criteria, severity classification and guidelines of localized scleroderma. J Dermatol. 2018;45(7):755–780. doi: 10.1111/1346-8138.14161.

33. Lythgoe H, Almeida B, Bennett J, et al. Multi-centre national audit of juvenile localised scleroderma: describing current UK practice in disease assessment and management. Pediatr Rheumatol Online J. 2018;16(1):80. doi: 10.1186/s12969-018-0295-0.

34. Saxton-Daniels S, Jacobe HT An evaluation of long-term outcomes in adults with pediatric-onset morphea. Arch Dermatol. 2010;146(9):1044–1045. doi: 10.1001/archdermatol.2010.239.

35. Zulian F, Vallongo C, Patrizi A, et al. A long-term follow-up study of methotrexate in juvenile localized scleroderma (morphea). J Am Acad Dermatol. 2012;67(6):1151–1156. doi: 10.1016/j.jaad.2012.03.036.

36. Torok KS, Arkachaisri T. Methotrexate and corticosteroids in the treatment of localized scleroderma: a standardized prospective longitudinal single-center study. J Rheumatol. 2012;39(2):286–94. doi: 10.3899/jrheum.110210.

37. Zulian F, Martini G, Vallongo C, et al. Methotrexate treatment in juvenile localized scleroderma: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2011;63(7):1998–2006. doi: 10.1002/art.30264.

38. Joly P, Bamberger N, Crickx B, et al. Treatment of severe forms of localized scleroderma with oral corticosteroids: follow-up study on 17 patients. Arch Dermatol. 1994;130(5):663–665.

39. Uziel Y, Feldman BM, Krafchik BR, et al. Methotrexate and corticosteroid therapy for pediatric localized scleroderma. J Pediatr. 2000;136(1):91–95. doi: 10.1016/s0022-3476(00)90056-8.

40. Martini G, Ramanan AV, Falcini F, et al. Successful treatment of severe or methotrexate-resistant juvenile localized scleroderma with mycophenolate mofetil. Rheumatology. 2009;48(11):1410–1413. doi: 10.1093/rheumatology/kep244.

41. Zulian F, Vallongo C, Woo P, et al. Localized scleroderma in childhood is not just a skin disease. Arthritis Rheum. 2005;52(9): 2873–2881. doi: 10.1002/art.21264.

42. Sheppard M, Laskou F, Stapleton PP, et al. Tocilizumab (Actemra). Hum Vaccin Immunother. 2017;13(9):1972–1988. doi: 10.1080/21645515.2017.1316909.

43. Ihn H, Sato S, Fujimoto M, et al. Demonstrationмof interleukin-2, interleukin-4 and interleukin-6 in sera from patients with localized scleroderma. Arch Dermatol Res. 1995;287(2):193–197. doi: 10.1007/BF01262331.

44. Nagaoka T, Sato S, Hasegawa M, et al. Serum levels of soluble interleukin 6 receptor and soluble gp130 are elevated in patients with localized scleroderma. J Rheumatol. 2000;27(8):1917–1921.

45. Khanna D, Denton CP, Lin CJF, et al. Safety and efficacy of subcutaneous tocilizumab in systemic sclerosis: results from the openlabel period of a phase II randomised controlled trial (faSScinate). Ann Rheum Dis. 2018;77(2):212–220. doi: 10.1136/annrheumdis-2017-211682.

46. Foeldvari I, Anton Lopez J, Friswell M, et al. Tocilizumab is a promising treatment option for therapy resistant juvenile localized scleroderma. J Scleroderma Relat Disord. 2017;2(3):203–207. doi: 10.5301/jsrd.5000259.

47. Martini G, Campus S, Raffeiner B, et al. Tocilizumab in two children with pansclerotic morphoea: a hopeful therapy for refractory cases? Clin Exp Rheumatol. 2017;35 Suppl 106(4):211–213.

48. Lythgoe H, Baildam E, Beresford MW, et al. Tocilizumab as a potential therapeutic option for children with severe, refractory juvenile localized scleroderma. Rheumatology (Oxford). 2018; 57(2):398–401. doi: 10.1093/rheumatology/kex382.

49. Dubois EA, Cohen AF. Abatacept. Br J Clin Pharmacol. 2009; 68(4):480–481. doi: 10.1111/j.1365-2125.2009.03502.x.

50. Bruni C, Praino E, Allanore Y, et al. Use of biologics and other novel therapies for the treatment of systemic sclerosis. Expert Rev Clin Immunol. 2017;13(5):469–482. doi: 10.1080/1744666X.2017.1263153.

51. Brunner HI, Tzaribachev N, Vega-Cornejo G, et al. Subcutaneous abatacept in patients with polyarticular-course juvenile idiopathic arthritis: results from a phase III open-label study. Arthritis Rheumatol. 2018;70(7):1144–1154. doi: 10.1002/art.40466.

52. Khanna D, Spino C, Johnson S, et al. Abatacept in early diffuse cutaneous systemic sclerosis— results of a phase 2 investigatorinitiated, multicenter, double- blind randomized placebo-controlled trial. Arthritis Rheumatol. 2020;72(1):125–136. doi: 10.1002/art.41055.

53. Fage SW, Arvesen KB, Olesen AB. Abatacept improves skin score and reduces lesions in patients with localized scleroderma: a case series. Acta Derm Venereol. 2018;98(4):465–466. doi: 10.2340/00015555-2878.

54. Chimenti MS, Teoli M, Di Stefani A, et al. Resolution with rituximab of localized scleroderma occurring during etanercept treatment in a patient with rheumatoid arthritis. Eur J Dermatol. 2013;23(2):273–274. doi: 10.1684/ejd.2013.1929.

55. Ferguson ID, Weiser P, Torok KS. A case report of successful treatment of recalcitrant childhood localized scleroderma with infliximab and leflunomide. Open Rheumatol J. 2015;9:30–35. doi: 10.2174/18743129014090100030.

56. Alcantara-Reifs CM, Garnacho-Saucedo GM, Salido-Vallejo R, et al. Imatinib treatment of therapy resistant generalized deep morphea. Dermatol Ther. 2015;28(5):271–273. doi: 10.1111/dth.12248.

57. Schoch JJ, Schoch BS, Werthel JD, et al. Orthopedic complications of linear morphea: Implications for early interdisciplinary care. Pediatr Dermatol. 2017;35(1):43–46. doi: 10.1111/pde.13336.

58. Torok KS. Pediatric scleroderma: systemic or localized forms. Pediatr Clin N Am. 2012;59:381–405. doi: 10.1016/j.pcl.2012.03.011.

59. Mugii N, Matsushita T, Oohata S, et al. Long-term follow-up of finger passive range of motion in Japanese systemic sclerosis patients treated with self-administered stretching. Mod Rheumatol. 2019;29(3):484–490. doi: 10.1080/14397595.2018.1466635.

60. Buckley SL, Skinner S, James P, Ashley RK. Focal scleroderma in children: an orthopaedic perspective. J Pediatr Orthop. 1993;13(6):784–790. doi: 10.1097/01241398-199311000-00020.

61. Ghanem I, Karam JA, Widmann RF. Surgical epiphysiodesis indications and techniques: update. Curr Opin Pediatr. 2011;23(1): 53–59. doi: 10.1097/MOP.0b013e32834231b3.

62. Daumas A, Magalon J, Delaunay F, et al. Fat Grafting for Treatment of Facial Scleroderma. Clin Plast Surg. 2020;47(1): 155–163. doi: 10.1016/j.cps.2019.08.016.

63. Strong AL, Rubin JP, Kozlow JH, Cederna PS. Fat Grafting for the Treatment of Scleroderma. Plast Reconstr Surg. 2019;144(6): 1498–1507. doi: 10.1097/PRS.0000000000006291.

64. Palmero ML, Uziel Y, Laxer RM, et al. En coup de sabre scleroderma and Parry-Romberg syndrome in adolescents: surgical options and patient-related outcomes. J Rheumatol. 2010;37(10): 2174–2179. doi: 10.3899/jrheum.100062.

65. Wollina U, Buslau M, Heinig B, et al. Disabling pansclerotic morphea of childhood poses a high risk of chronic ulceration of the skin and squamous cell carcinoma. Int J Low Extrem Wounds. 2007;6(4):291–298. doi: 10.1177/1534734607308731.

66. Piram M, McCuaig CC, Saint-Cyr C, et al. Short- and long-term outcome of linear morphoea in children. Br J Dermatol. 2013; 169(6):1265–1271. doi: 10.1111/bjd.12606.

67. Ardalan K, Zigler C, Torok K. Predictors of longitudinal quality of life in juvenile localized scleroderma. Arthritis Care Res. 2017; 69(7):1082–1087. doi: 10.1002/acr.23101.


Для цитирования:


Раупов Р.К., Костик М.М. Ювенильная локализованная склеродермия. Вопросы лечения. Вопросы современной педиатрии. 2020;19(3):228-234. https://doi.org/10.15690/vsp.v19i3.2119

For citation:


Raupov R.K., Kostik M.M. Juvenile Localized Scleroderma. Questions of Treatment. Current Pediatrics. 2020;19(3):228-234. (In Russ.) https://doi.org/10.15690/vsp.v19i3.2119

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