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MORPHEA'S EPIDEMIOLOGY IN CEARA, BRAZIL: A RETROSPECTIVE STUDY
Localized scleroderma, or morphea, is a rare fibrosing disorder of the skin and underlying tissues. Patients with morphea have a variable spectrum of clinical manifestations, from small sclerotic plaques to large deformities. The initial lesion is characterized by erythema, evolving to plaques and, when the cutaneous infiltration occurs, atrophy and hypo or hyperpigmentation.
The epidemiological data about scleroderma in Brazil is scarce, and most studies focus on the systemic form of the disease. Our study is focused on morphea, its prevalence and epidemiology in the state of Ceará.
Materials and methods
We adopted a retrospective design using a quantitative approach, based on medical records of patients who attended appointments in the most important dermatology center in our state, from january to december of 2015. A total of 19.576 patients were seen in that time period. We selected patients diagnosed with morphea.
We found 124 patients diagnosed with morphea, representing a prevalence of 0,62% in the center in 2015. 96 (77,42%) of them were women and 28 (22,58%) were men. The mean age was 29,7 years.
Out of the 124 patients, 22 (17,74%) had another dermatologic pathologies. Vitiligo was found in 6 patients.
Previous studies show a prevalence of morphea between 0,4-2,7 per 100.000. Considering that almost all, if not all, cases of morphea are referred to our Center, we found an estimated prevalence of 1,39 per 100.000 in our population, agreeing with the literature. The gender prevalence also matched that of previous studies: the literature shows a female predominance of 2,4 to 4,2:1; we found a 3,4:1 proportion.
While others showed that the prevalence of the disease appears to be equal in adults and children, out study had an adult predominance of 1,6:1.
There are several case reports implicating autoimmunity as the underlying cause in morphea and associating it with other autoimmune diseases. The association with vitiligo has been reported, but mostly in isolated cases. We found that 4,8% of our patients had vitiligo, but we couldn’t find studies that showed the prevalence of this association to compare to our study.
Morphea is a rare disease with a incompletely understood pathogenesis. The brazilian literature lacks studies about localized morphea, thus making it harder to understand its prevalence, risk factors and associations with other diseases. To the best of our knowledge, ours might be the first brazilian epidemiologic study about localized scleroderma. More studies and necessary to understand the disease in our population.
LEVI COELHO MAIA BARROS, THAIS CAMPELO BEDE VALE, MATHEUS EUGENIO DE SOUSA LIMA, MARIANA ROCHA MAIA, MARIA ARACI PONTES AIRES, LUIS RICARDO de SALES MENESES FILHO