APLAR Grand Round Blackboard 2023

Question 1

Which of the following statements are true?
Question 1
- A. Generalized morphea may cause sclerodactyly.
- B. Skin biopsy findings can differentiate between morphea and systemic sclerosis.
- C. Arthralgia is the most common extracutaneous manifestation of morphea.
- D. There is an infiltration of predominantly macrophages and plasma cells in the skin lesions due to morphea.
- E. Anti-topoisomerase II alpha antibody is much more commonly found in patients with morphea than in patients with other autoimmune diseases.
Your Answer is Incorrect

Answer with Detailed explanation
A. False
Morphea is differentiated from systemic sclerosis by the absence of sclerodactyly, Raynaud’s phenomenon and nailfold capillary changes.
B. False
Morphea and systemic sclerosis share similar histopathologic features.
C. True
D. False
A perivascular infiltrate of predominantly lymphocytes with admixed rare plasma cells and eosinophils is seen in the reticular dermis in the early stage of morphea and systemic sclerosis.
E. True
Anti-topoisomerase II alpha is found in 76% of all patients with morphea and 85% of patients with generalised morphea. On the other hand, it is encountered in only 14% of patients with systemic sclerosis and 8% of patients with SLE.
Your Answer is Correct

Answer with Detailed explanation
A. False
Morphea is differentiated from systemic sclerosis by the absence of sclerodactyly, Raynaud’s phenomenon and nailfold capillary changes.
B. False
Morphea and systemic sclerosis share similar histopathologic features.
C. True
D. False
A perivascular infiltrate of predominantly lymphocytes with admixed rare plasma cells and eosinophils is seen in the reticular dermis in the early stage of morphea and systemic sclerosis.
E. True
Anti-topoisomerase II alpha is found in 76% of all patients with morphea and 85% of patients with generalised morphea. On the other hand, it is encountered in only 14% of patients with systemic sclerosis and 8% of patients with SLE.

Question 2

Which one of the following is the first-line pharmacological agent to treat morphea?
Question 2
- A. Hydroxychloroquine
- B. Methotrexate
- C. Azathioprine
- D. Mycophenolate mofetil
- E. Cyclosporine
Your Answer is Incorrect

Answer with Detailed explanation
B. Methotrexate
Methotrexate is the current first-line treatment for subtypes of morphea with severe skin affection or musculoskeletal involvement.
Reference
Fett N, Werth VP. Update on morphea: part I. Epidemiology, clinical presentation, and pathogenesis. Journal of the American Academy of Dermatology. 2011 Feb 1;64(2):217-28.
Knoblet R, Moinzadeh P, Hunzelmann N, Kreuter A, Cozzio A, Mouthon L, Cutolo M, Rongioletti F, Denton CP, Rudnicka L, Frasin LA. European Dermatology Forum S1‐guideline on the diagnosis and treatment of sclerosing diseases of the skin, Part 1: localized scleroderma, systemic sclerosis and overlap syndromes. Journal of the European Academy of Dermatology and Venereology. 2017 Sep;31(9):1401-24.
By Dr A T M Tanveer Hasan, Associate Professor of Rheumatology, Enam Medical College & Hospital, Savar, Dhaka, Bangladesh
Your Answer is Correct

Answer with Detailed explanation
B. Methotrexate
Methotrexate is the current first-line treatment for subtypes of morphea with severe skin affection or musculoskeletal involvement.
Reference
Fett N, Werth VP. Update on morphea: part I. Epidemiology, clinical presentation, and pathogenesis. Journal of the American Academy of Dermatology. 2011 Feb 1;64(2):217-28.
Knoblet R, Moinzadeh P, Hunzelmann N, Kreuter A, Cozzio A, Mouthon L, Cutolo M, Rongioletti F, Denton CP, Rudnicka L, Frasin LA. European Dermatology Forum S1‐guideline on the diagnosis and treatment of sclerosing diseases of the skin, Part 1: localized scleroderma, systemic sclerosis and overlap syndromes. Journal of the European Academy of Dermatology and Venereology. 2017 Sep;31(9):1401-24.
By Dr A T M Tanveer Hasan, Associate Professor of Rheumatology, Enam Medical College & Hospital, Savar, Dhaka, Bangladesh

Step 1 of 2

Question 1

Which of the following statements are true?

Your Answer is Incorrect

Answer with Detailed explanation

Your Answer is Correct

Answer with Detailed explanation

Question 2

Which one of the following is the first-line pharmacological agent to treat morphea?

Your Answer is Incorrect

Answer with Detailed explanation

Your Answer is Correct

Answer with Detailed explanation

Past APLAR Grand Round Blackboard

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