Inflammatory arthritis in pediatric patients with morphea

The number of studies demonstrated that over 25% of patients with morphea and arthralgia had articular involvement unrelated to the site of the skin lesions. But the co-existence of inflammatory arthritis and morphea is not well-described in the literature. The results of the present study showed that pediatric morphea co-existed with inflammatory arthritis in 11/53 children.

Morphea is an inflammatory disease inducing fibrosis of the skin and subcutaneous tissues. Arthralgias, Joint contractures, and practical compromise are the acknowledged associations of the pediatric morphea. However, the co-existence between morphea and inflammatory arthritis is not well-established in the literature. The study aimed to determine the association of pediatric morphea with inflammatory arthritis regarding musculoskeletal, cutaneous and laboratory outcomes along with treatment therapies.

A total of 53 individuals with pediatric morphea was selected and identified for morphea subtypes, serum autoantibodies, arthritic joint involvement, and therapeutic approaches.

A total 11 out of 53 individuals found to have polyarthritis which included joints independent to the site of the cutaneous morphea. Most of the patients were the females and exhibited either the generalised or linear subtypes of morphea. Further, the arthritis patients presented with elevated serum levels of antinuclear antibodies. Methotrexate along with other topical/systemic immunosuppressive agents was used as the treatment.  

Eleven children showed pediatric morphea along with inflammatory arthritis. Additional research is required to find more intensive therapy and musculoskeletal screening.