The fasciitis-morphea complex in children

J. J. Miller 3rd
Lucille Salter Packard Children's Hospital, Stanford, Palo Alto, CA 94304.

OBJECTIVE--To describe the clinical presentation and treatment of the combined syndrome of fasciitis and morphea in children. SETTING--The rheumatic disease clinic of a university children's hospital. PATIENTS--Six children who were referred for signs or symptoms of fasciitis were observed. SELECTION PROCEDURES--All children who were referred for fasciitis were included in the study. INTERVENTIONS--Therapy included prednisone initially and subsequent long-term treatment with penicillamine and alternate-day doses of prednisone. MEASUREMENTS AND RESULTS--Symptoms of morphea appeared 1 year before to 4 years after the first signs of fasciitis were observed. The fasciitis was characterized by usually symmetrical, centrifugal swelling, pain, and contracture formation. The morphea and fasciitis did not appear in the same areas of the body. CONCLUSIONS--The fasciitis and morphea are clearly linked manifestations. The fasciitis, but not the morphea, appears to respond to treatment with steroids. Treatment with penicillamine may ameliorate the sclerosis of the morphea but does not stop new lesions from appearing.