A Case Report of Successful Treatment of Recalcitrant Childhood Localized Scleroderma with Infliximab and Leflunomide



Ian D Ferguson 1, Peter Weiser 2, Kathryn S Torok*, 1
1 Department of Pediatrics, Division of Rheumatology, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
2 Department of Pediatrics, Division of Rheumatology, Children’s of Alabama, University of Alabama at Birmingham, 1600 7th Ave S, CPP North M210, Birmingham, AL, 35233, USA


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© Ferguson et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Pediatrics, Division of Rheumatology, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, 4401 Penn Avenue, Pittsburgh, PA 15224, USA; Tel: 412-692-5081; E-mail: kathryn.torok@chp.edu


Abstract

Herein we report successful treatment of an adolescent Caucasian female with severe progressive localized scleroderma (mixed subtype, including generalized morphea and linear scleroderma of the trunk/limb) using infliximab and leflunomide. The patient demonstrated improvement after the first 9 months of therapy based on her clinical examination, objective measures, and patient and parent global assessments. Infliximab is a potential treatment option for pediatric localized scleroderma patients who have progression of disease or who are unable to tolerate the side effect profile of more standard systemic therapy. Larger longitudinal studies or case series are needed to confirm and further investigate infliximab’s role in localized scleroderma.

Keywords: Infliximab, leuflunomide, localized scleroderma, morphea, pediatric rheumatology.