Pulsed High-Dose Corticosteroids Combined With Low-Dose Methotrexate in Severe Localized Scleroderma

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Abstract
Localized scleroderma (LS) or morphea denotes a spectrum of disorders characterized by hardening and thickening of different levels of the dermis, subcutis, and sometimes underlying soft tissue and bone. Localized scleroderma has been classified into plaque, generalized, bullous, linear including scleroderma en coup de sabre, and deep forms such as morphea profunda.1 Hence, the clinical spectrum of LS ranges from discrete, circumscribed sclerotic plaques of cosmetic importance only to more severe variants that may have devastating effects, such as growth retardation, muscle atrophy, flexion contractures, and psychological disability. The etiology of LS remains unknown, but autoimmune, genetic, infectious, and environmental factors have been implicated.