Juvenile Localized Scleroderma

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Duke pediatric rheumatologists identify the type of scleroderma affecting your child and use the latest therapies to reduce symptoms and minimize damage to skin, muscle, joints, and bones. Our team also helps your child learn to cope with the condition and its visible effects as they develop.

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Tests

There are several subtypes of juvenile scleroderma -- linear scleroderma, circumscribed morphea, generalized morphea, scleroderma en coup de sabre, and deeper lesions such as eosinophilic fasciitis. Your child’s pediatric rheumatologist may perform one or more of the following tests to diagnose the type of scleroderma affecting your child and to determine the most effective way to control the condition.

Physical Exam

Localized scleroderma typically causes a skin rash that grows longer and/or deeper over time. It may affect one site or multiple sites on the body. It may result in long red, purple, or brown streaks on the arms, legs, or torso. A physical exam of your child’s skin involvement will help to diagnose the type of juvenile localized scleroderma affecting your child. We will also look for related conditions, such as arthritis or inflammation in the eye.

Blood Tests

Blood work will be performed to look for autoantibodies, evidence of muscle involvement, and indicators of disease activity.

Skin Biopsy

A small sample of skin or underlying tissue may be removed and studied under the microscope to confirm the diagnosis.

CT, MRI, Ultrasound

Imaging tests help your doctor rule out infections or other problems. They also show whether the skin damage affects a joint, muscles, or bones. This can affect your child’s ability to move and function and may require more aggressive treatment.

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Treatments

While there is no cure for juvenile localized scleroderma, your child’s pediatric rheumatologist will recommend an appropriate treatment that is dependent on the type and size of the skin involvement. Ongoing medical care is needed to manage therapies that control the disease, prevent serious complications, and put the disease into remission. Eventually, we will attempt to taper your child off these medications.

Topical Medications

Skin creams and ointments can help relieve dryness and itching and may help the underlying inflammation.

Systemic Immune Suppressants

Corticosteroids and methotrexate can suppress the immune system to reduce the risk or limit the amount of long-term damage.

Physical and Occupational Therapy

Depending on the extent of your child’s symptoms, physical or occupational therapy may be recommended to help your child strengthen muscles, improve mobility, and learn more efficient ways to perform everyday tasks.

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Why Choose Duke

National Partners in Research and Treatment
Our pediatric rheumatologists are helping to lead national efforts to better understand how juvenile scleroderma starts and spreads, and the best treatment approaches. As members of the Childhood Arthritis and Rheumatology Research Alliance, we helped develop and are now testing a standard approach to treating juvenile localized scleroderma. Our goal is to make sure children with the condition find effective treatment no matter where they live.

Partners with Pediatric Specialists
When necessary, our pediatric rheumatologists partner with other Duke pediatric specialists, including dermatologists and neurologists, to diagnose your child’s condition and to manage skin lesions and other complications.

Support for Your Child and Your Family
Our social worker can help your child cope if skin damage affects their mobility or self-esteem. We can arrange accommodations to help your child keep up with their schoolwork, or provide counseling to children who need help coping with teasing or other social anxieties.

Transition to Adult Care
We help your child transition his or her care to an adult rheumatologist to ensure their care continues as they grow into adulthood.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

This page was medically reviewed on 05/25/2018 by

C. Egla Rabinovich, MD, MPH | Pediatric Rheumatologist