Overlap Syndrome (Localized Scleroderma and Discoid Lupus Erythematosus) in a Child: Case Study
Nikolay N. Murashkin,
Alexandr I. Materikin,
Yaroslav Yu. Alshevskiy,
Roman V. Epishev,
Mariya A. Leonova,
Leonid A. Opryatin,
Roman A. Ivanov,
Ekaterina S. Pavlova,
Oksana R. Katunina,
Kirill A. Kulikov https://doi.org/10.15690/vsp.v24i4.2935
Abstract
Background. The combination of systemic scleroderma and systemic lupus erythematosus is described sufficiently detailed in the literature. However, overlap of localized forms of scleroderma and discoid lupus erythematosus in children is described only in single clinical observations. Case description. Rare case study of overlap syndrome is presented, the results of drug treatment are demonstrated, differential diagnosis issues and disease pathogenetic features are highlighted. Conclusion. Diagnosis of overlap syndromes presents significant difficulties. Its untimely verification leads to ineffective management. As a result, persistent functional and cosmetic skin defects develop, leading to negative impact on patients' quality of life.
Keywords
Supporting agencies: Not specified.
About the Authors
Nikolay N. Murashkin
National Medical Research Center of Children’s Health; Sechenov First Moscow State Medical University; Central State Medical Academy of Department of Presidential Affairs
Russian Federation
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
Nikolay N. Murashkin — receiving research grants from pharmaceutical companies Jansen, Eli Lilly, Novartis. Receiving fees for scientific counseling from companies Galderna, Pierre Fabre, Bayer, Leopharma, Pfizer, AbbVie, Amryt Pharma, Celgene, Mölnlycke Health Care AB, Zeldis Pharma. Leonid A. Opryatin — receiving fees for scientific counseling from companies Eli Lilly, Jansen. Alexandr I. Materikin, Roman V. Epishev — receiving research grants from pharmaceutical companies Eli Lilly, Novartis, AbbVie, Amryt Pharma, Jansen, Pfizer, Celgene. Receiving fees for scientific counseling from company Mölnlycke Health Care AB. Other authors confirmed the absence of a reportable conflict of interests.
Alexandr I. Materikin
National Medical Research Center of Children’s Health
Russian Federation
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
Nikolay N. Murashkin — receiving research grants from pharmaceutical companies Jansen, Eli Lilly, Novartis. Receiving fees for scientific counseling from companies Galderna, Pierre Fabre, Bayer, Leopharma, Pfizer, AbbVie, Amryt Pharma, Celgene, Mölnlycke Health Care AB, Zeldis Pharma. Leonid A. Opryatin — receiving fees for scientific counseling from companies Eli Lilly, Jansen. Alexandr I. Materikin, Roman V. Epishev — receiving research grants from pharmaceutical companies Eli Lilly, Novartis, AbbVie, Amryt Pharma, Jansen, Pfizer, Celgene. Receiving fees for scientific counseling from company Mölnlycke Health Care AB. Other authors confirmed the absence of a reportable conflict of interests.
Yaroslav Yu. Alshevskiy
Central State Medical Academy of Department of Presidential Affairs
Russian Federation
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
Nikolay N. Murashkin — receiving research grants from pharmaceutical companies Jansen, Eli Lilly, Novartis. Receiving fees for scientific counseling from companies Galderna, Pierre Fabre, Bayer, Leopharma, Pfizer, AbbVie, Amryt Pharma, Celgene, Mölnlycke Health Care AB, Zeldis Pharma. Leonid A. Opryatin — receiving fees for scientific counseling from companies Eli Lilly, Jansen. Alexandr I. Materikin, Roman V. Epishev — receiving research grants from pharmaceutical companies Eli Lilly, Novartis, AbbVie, Amryt Pharma, Jansen, Pfizer, Celgene. Receiving fees for scientific counseling from company Mölnlycke Health Care AB. Other authors confirmed the absence of a reportable conflict of interests.
Roman V. Epishev
National Medical Research Center of Children’s Health
Russian Federation
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
Nikolay N. Murashkin — receiving research grants from pharmaceutical companies Jansen, Eli Lilly, Novartis. Receiving fees for scientific counseling from companies Galderna, Pierre Fabre, Bayer, Leopharma, Pfizer, AbbVie, Amryt Pharma, Celgene, Mölnlycke Health Care AB, Zeldis Pharma. Leonid A. Opryatin — receiving fees for scientific counseling from companies Eli Lilly, Jansen. Alexandr I. Materikin, Roman V. Epishev — receiving research grants from pharmaceutical companies Eli Lilly, Novartis, AbbVie, Amryt Pharma, Jansen, Pfizer, Celgene. Receiving fees for scientific counseling from company Mölnlycke Health Care AB. Other authors confirmed the absence of a reportable conflict of interests.
Mariya A. Leonova
National Medical Research Center of Children’s Health
Russian Federation
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
Nikolay N. Murashkin — receiving research grants from pharmaceutical companies Jansen, Eli Lilly, Novartis. Receiving fees for scientific counseling from companies Galderna, Pierre Fabre, Bayer, Leopharma, Pfizer, AbbVie, Amryt Pharma, Celgene, Mölnlycke Health Care AB, Zeldis Pharma. Leonid A. Opryatin — receiving fees for scientific counseling from companies Eli Lilly, Jansen. Alexandr I. Materikin, Roman V. Epishev — receiving research grants from pharmaceutical companies Eli Lilly, Novartis, AbbVie, Amryt Pharma, Jansen, Pfizer, Celgene. Receiving fees for scientific counseling from company Mölnlycke Health Care AB. Other authors confirmed the absence of a reportable conflict of interests.
Leonid A. Opryatin
National Medical Research Center of Children’s Health
Russian Federation
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
Nikolay N. Murashkin — receiving research grants from pharmaceutical companies Jansen, Eli Lilly, Novartis. Receiving fees for scientific counseling from companies Galderna, Pierre Fabre, Bayer, Leopharma, Pfizer, AbbVie, Amryt Pharma, Celgene, Mölnlycke Health Care AB, Zeldis Pharma. Leonid A. Opryatin — receiving fees for scientific counseling from companies Eli Lilly, Jansen. Alexandr I. Materikin, Roman V. Epishev — receiving research grants from pharmaceutical companies Eli Lilly, Novartis, AbbVie, Amryt Pharma, Jansen, Pfizer, Celgene. Receiving fees for scientific counseling from company Mölnlycke Health Care AB. Other authors confirmed the absence of a reportable conflict of interests.
Roman A. Ivanov
National Medical Research Center of Children’s Health
Russian Federation
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
Nikolay N. Murashkin — receiving research grants from pharmaceutical companies Jansen, Eli Lilly, Novartis. Receiving fees for scientific counseling from companies Galderna, Pierre Fabre, Bayer, Leopharma, Pfizer, AbbVie, Amryt Pharma, Celgene, Mölnlycke Health Care AB, Zeldis Pharma. Leonid A. Opryatin — receiving fees for scientific counseling from companies Eli Lilly, Jansen. Alexandr I. Materikin, Roman V. Epishev — receiving research grants from pharmaceutical companies Eli Lilly, Novartis, AbbVie, Amryt Pharma, Jansen, Pfizer, Celgene. Receiving fees for scientific counseling from company Mölnlycke Health Care AB. Other authors confirmed the absence of a reportable conflict of interests.
Ekaterina S. Pavlova
National Medical Research Center of Children’s Health
Russian Federation
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
Nikolay N. Murashkin — receiving research grants from pharmaceutical companies Jansen, Eli Lilly, Novartis. Receiving fees for scientific counseling from companies Galderna, Pierre Fabre, Bayer, Leopharma, Pfizer, AbbVie, Amryt Pharma, Celgene, Mölnlycke Health Care AB, Zeldis Pharma. Leonid A. Opryatin — receiving fees for scientific counseling from companies Eli Lilly, Jansen. Alexandr I. Materikin, Roman V. Epishev — receiving research grants from pharmaceutical companies Eli Lilly, Novartis, AbbVie, Amryt Pharma, Jansen, Pfizer, Celgene. Receiving fees for scientific counseling from company Mölnlycke Health Care AB. Other authors confirmed the absence of a reportable conflict of interests.
Oksana R. Katunina
National Medical Research Center of Children’s Health
Russian Federation
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
Nikolay N. Murashkin — receiving research grants from pharmaceutical companies Jansen, Eli Lilly, Novartis. Receiving fees for scientific counseling from companies Galderna, Pierre Fabre, Bayer, Leopharma, Pfizer, AbbVie, Amryt Pharma, Celgene, Mölnlycke Health Care AB, Zeldis Pharma. Leonid A. Opryatin — receiving fees for scientific counseling from companies Eli Lilly, Jansen. Alexandr I. Materikin, Roman V. Epishev — receiving research grants from pharmaceutical companies Eli Lilly, Novartis, AbbVie, Amryt Pharma, Jansen, Pfizer, Celgene. Receiving fees for scientific counseling from company Mölnlycke Health Care AB. Other authors confirmed the absence of a reportable conflict of interests.
Kirill A. Kulikov
National Medical Research Center of Children’s Health
Russian Federation
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
Nikolay N. Murashkin — receiving research grants from pharmaceutical companies Jansen, Eli Lilly, Novartis. Receiving fees for scientific counseling from companies Galderna, Pierre Fabre, Bayer, Leopharma, Pfizer, AbbVie, Amryt Pharma, Celgene, Mölnlycke Health Care AB, Zeldis Pharma. Leonid A. Opryatin — receiving fees for scientific counseling from companies Eli Lilly, Jansen. Alexandr I. Materikin, Roman V. Epishev — receiving research grants from pharmaceutical companies Eli Lilly, Novartis, AbbVie, Amryt Pharma, Jansen, Pfizer, Celgene. Receiving fees for scientific counseling from company Mölnlycke Health Care AB. Other authors confirmed the absence of a reportable conflict of interests.
References
1. Magro CM, Schwartz Z. Intralesional overlap syndrome: Sclerodermic lupus panniculitis and sclerodermic discoid lupus erythematosus. JAAD Case Rep. 2020;6(2):146–149. doi: https://doi.org/10.1016/j.jdcr.2019.12.006
2. Batu ED, Günalp A, Şahin S, et al. Pediatric mixed connective tissue disease versus other overlap syndromes: a retrospective multicenter cohort study. Rheumatol Int. 2023;43(8):1485–1495. doi: https://doi.org/10.1007/s00296-023-05300-x
3. Denton CP, Khanna D. Systemic sclerosis. Lancet. 2017;390(10103): 1685–1699. doi: https://doi.org/10.1016/S0140-6736(17)30933-9
4. Scherlinger M, Guillotin V, Truchetet ME, et al. Systemic lupus erythematosus and systemic sclerosis: All roads lead to platelets. Autoimmun Rev. 2018;17(6):625–635. doi: https://doi.org/10.1016/j.autrev.2018.01.012
5. Sárdy M, Ruzicka T, Kuhn A. Topical calcineurin inhibitors in cutaneous lupus erythematosus. Arch Dermatol Res. 2009;301(2): 93–98. doi: https://doi.org/10.1007/s00403-008-0894-6
6. Lu J, Liu Q, Wang L, et al. Increased expression of latent TGF-β-binding protein 4 affects the fibrotic process in scleroderma by TGF-β/SMAD signaling. Lab Invest. 2017;97(9):1121. doi: https://doi.org/10.1038/labinvest.2017.43
7. Man XY, Finnson KW, Baron M, Philip A. CD109, a TGF-β co-receptor, attenuates extracellular matrix production in scleroderma skin fibroblasts. Arthritis Res Ther. 2012;14(3):R144. doi: https://doi.org/10.1186/ar3877
8. Robinson ES, Werth VP. The role of cytokines in the pathogenesis of cutaneous lupus erythematosus. Cytokine. 2015;73(2):326–334. doi: https://doi.org/10.1016/j.cyto.2015.01.031
9. Wenzel J. Cutaneous lupus erythematosus: new insights into pathogenesis and therapeutic strategies. Nat Rev Rheumatol. 2019; 15(9):519–532. doi: https://doi.org/10.1038/s41584-019-0272-0
10. Cardoneanu A, Burlui AM, Macovei LA, et al. Targeting systemic sclerosis from pathogenic mechanisms to clinical manifestations: Why IL-6? Biomedicines. 2022;10(2):318. doi: https://doi.org/10.3390/biomedicines10020318
11. Piroozmand A, Dabbaghmanesh MH, Omrani GR, et al. Serum interleukin-6 level and its association with pulmonary involvement in progressive systemic sclerosis: a case-control study. Clin Mol Allergy. 2023;21(1):7. doi: https://doi.org/10.1186/s12948-023-00188-1
12. Shima Y. Cytokines involved in the pathogenesis of systemic sclerosis: potential therapeutic targets. Cells. 2021;10(5):1104. doi: https://doi.org/10.3390/cells10051104
13. Al-Gburi S, Moinzadeh P, Krieg T. Pathophysiology in Systemic Sclerosis: Current Insights and Future Perspectives. Sclerosis. 2025;3(2):17. doi: https://doi.org/10.3390/sclerosis3020017
14. Bellando-Randone S, Della-Torre E, Balanescu A. The role of interleukin-17 in the pathogenesis of systemic sclerosis: Pro-fibrotic or anti-fibrotic? J Scleroderma Relat Disord. 2021;6(3):227–235. doi: https://doi.org/10.1177/23971983211039421
15. Xing X, Yang J, Yang X, et al. IL-17A induces endothelial inflammation in systemic sclerosis via the ERK signaling pathway. PLoS One. 2013;8(12):e85032. doi: https://doi.org/10.1371/journal.pone.0085032
16. Shima Y. Interleukin-6 in the Pathogenesis of Systemic Sclerosis. In: Systemic Sclerosis. Takehara K, Fujimoto M, Kuwana M, eds. Tokyo: Springer; 2016. pp. 103–115. https://doi.org/10.1007/978-4-431-55708-1_7
17. Huangfu L, Li R, Huang Y, Wang S. The IL-17 family in diseases: from bench to bedside. Signal Transduct Target Ther. 2023;8(1):402. doi: https://doi.org/10.1038/s41392-023-01620-3
18. Chasset F, Frances C. Current concepts and future approaches in the treatment of cutaneous lupus erythematosus: a comprehensive. Drugs. 2019;79(11):1199–1215. doi: https://doi.org/10.1007/s40265-019-01151-8
19. Inamo Y, Ochiai T. Successful combination treatment of a patient with progressive juvenile localized scleroderma (morphea) using imatinib, corticosteroids, and methotrexate. Pediatr Dermatol. 2013;30(6):e191–e193. doi: https://doi.org/10.1111/j.1525-1470.2012.01882.x
20. Qayoom S, Rather S, Manzoor S, Sameen F. Evaluation of corticosteroid and methotrexate therapy in the treatment of moderate to severe localized scleroderma (morphea) — A 5 year study in a teaching hospital of North India. Int J Contemp Med Res. 2019;6(5):E1–E4. doi: https://doi.org/10.21276/ijcmr.2019.6.5.11
Review
For citations:
Murashkin N.N., Materikin A.I., Alshevskiy Ya.Yu., Epishev R.V., Leonova M.A., Opryatin L.A., Ivanov R.A., Pavlova E.S., Katunina O.R., Kulikov K.A. Overlap Syndrome (Localized Scleroderma and Discoid Lupus Erythematosus) in a Child: Case Study. Current Pediatrics. 2025;24(4):262-266. (In Russ.) https://doi.org/10.15690/vsp.v24i4.2935
Views:
2
Email this article 
