Body Site Distribution of Pediatric-Onset Morphea and Association with Extracutaneous Manifestations.

The distribution of pediatric-onset morphea and site-based likelihood for extracutaneous complications has not been well-characterized.Characterize lesional distribution of pediatric-onset morphea and determine sites with the highest association with extracutaneous manifestations.A retrospective cross-sectional study was performed. Using clinical photographs, morphea lesions were mapped onto body diagrams using customized software.There were 823 patients with 2522 lesions included. Lesions were more frequent on the superior (versus inferior) anterior head and extensor (versus flexor) extremities. Linear morphea lesions were more likely on the head and neck, while plaque and generalized morphea lesions were more likely on the trunk. Musculoskeletal complications were more likely with lesions on the extensor (versus flexor) extremity (OR 2.0, 95% CI: 1.2-3.4), while neurologic manifestations were more likely with lesions on the anterior (versus posterior) head (OR 2.8, 95% CI: 1.7-4.6) and superior (versus inferior) head (OR 2.3, 95% CI: 1.6-3.4).Retrospective nature and inclusion of only patients with clinical photographs.The distribution of pediatric-onset morphea is not random and varied by body site and within individual body sites. The risk stratification of extracutaneous manifestations by body site may inform decisions about screening for extracutaneous manifestations, although prospective studies are needed.

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Authors: Yvonne E Chiu, Leonid Shmuylovich, Tina Kiguradze, Katelyn Anderson, Cathryn Sibbald, Megha Tollefson, Elaine Kunzler, Wynnis L Tom, Kelsie Bond, Regina-Celeste Ahmad, Maria Teresa Garcia-Romero, Mahwish Irfan, Kaitlyn Kollman, Raegan Hunt, Sarah L Stein, Lisa Arkin, Vivian Wong, Elena Pope, Heidi Jacobe, Heather A Brandling-Bennett, Kelly M Cordoro, Lionel Bercovitch, Stephanie M Rangel, Xuerong Liu, Aniko Szabo, Amy S Paller