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. 2023 Mar;29(3):e13300.
doi: 10.1111/srt.13300.

Study about evaluation of efficacy of methotrexate in localized scleroderma using ultrasonography

Fan Zhang  1 , Jianke Li  1 , Qing Zhao  1 , Hong Liu  1 , Furen Zhang  1
Affiliations

Study about evaluation of efficacy of methotrexate in localized scleroderma using ultrasonography

Fan Zhang et al. Skin Res Technol. 2023 Mar.

Abstract

Background: The treatment and curative effect evaluation of localized scleroderma (LS) still perplexes many clinical workers.

Purpose: To investigate the efficiacy of methotrexate in the treatment of LS by the evaluation of ultrasonography.

Methods: A prospective study enrolled 10 patients treated with MTX for at least 6 months was conducted. Treatment outcome was evaluated by a clinical score and 15-MHz ultrasonography. Safety assessment included the monitoring of adverse drug reactions and clinical laboratory examinations.

Results: Eight of the 10 patients achieved clinical remission only with MTX. One patient was relieved after MTX combined with corticosteroids, while another one does not improve after the treatment of mycophenolate mofetil and corticosteroids. The effective rate of MTX is 80%. Nine patients were significantly improved with a decrease of the Localized Scleroderma Cutaneous Assessment Tool (the mean score of the LoSCAT cutaneous activity dropped from 5.2 to 1.0, p < 0.001, the mean score of the LS cutaneous damage dropped from 4.3 to 2.3, p = 0.002). The average difference of thickness between skin lesions and normal skin evaluated by ultrasonography decreased from 0.13 cm to 0.04 cm (p = 0.009) in eight patients. No serious adverse reactions occurred.

Conclusion: Methotrexate is a safe and effective treatment for patients with LS. Ultrasonography can be considered as an efficient assessment tool for evaluation LS.

Keywords: evaluate; methotrexate; morphea; ultrasonography.

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Conflict of interest statement

The author reports no conflict of interest in this work.

Figures

FIGURE 1
FIGURE 1
Treatment algorithm for nine patients.
FIGURE 2
FIGURE 2
Changes of LoSCAT score and lesion thickness in patient 5.
FIGURE 3
FIGURE 3
(A and B) Localized morphea lesions on the groin. The hardness, pigmentation, and atrophy of the skin lesions were significantly improved during the 6‐month treatment period. (C and D) Changes of skin thickness (the part indicated by the red bracket) before and after treatment under ultrasonography monitoring (skin thickness decreased from 0.21 cm to 0.18 cm).
FIGURE 4
FIGURE 4
(A and B) En coup de sabre (linear morphea subtype) affecting the forehead and scalp. During the treatment period of 8 months, the hair regenerated and the area of hypopigmented spots decreased.
See this image and copyright information in PMC

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