Episode 29 - Localized scleroderma in Finland

In this episode of BJD Talks, Sam and Meera discuss the article ‘Localized scleroderma and related comorbidities: a single-centre cohort study’ by Kortelainen et al. The full article can be accessed at https://doi.org/10.1093/bjd/ljaf419 

*This podcast was generated by an AI tool created by 67Bricks for the British Association of Dermatologists*

Transcript

SPEAKER_00 0:00

Welcome to BJD Talks, the official podcast of the BJD. I'm Sam.

SPEAKER_01 0:04

And I'm Mira. In this episode, we will be discussing the article by Sarah Kortolinen et al. Localised Scleroderma and Related Comorbidities, a single centre cohort study from October 2025 and included in the February 2026 issue.

SPEAKER_00 0:20

Localised scleroderma, or morphia, is a rare autoimmune condition that hardens the skin and sometimes the tissues underneath, requiring specialised care. Mira, what struck you most about this study?

SPEAKER_01 0:32

The depth of the dataset. Covering 155 patients from 2005 to 2020 in South West Finland, it offers rare insights into the condition's prevalence and management. They report an annual incidence of 1.62 cases per 100,000 people, aligning with global trends. Notably, over 80% of patients were female.

SPEAKER_00 0:56

Yes, and the incidence peaks at two stages, childhood and middle age. The study uses the European Dermatology Forum's classification, detailing five subtypes limited, generalized, linear, deep, and mixed. Limited morphia was most common, appearing in 45.8% of cases.

SPEAKER_01 1:15

The link with other autoimmune diseases is particularly striking. 29% of patients had at least one other autoimmune condition, most often thyroid diseases like Hashimoto's thyroiditis or Graves' disease. A smaller number were diagnosed with lichen sclerosis or rheumatoid arthritis. Interestingly, autoimmune thyroid disease was frequently diagnosed before morphia.

SPEAKER_00 1:40

That appears consistent with their focus on adult onset comorbidities. The malignancy findings are worth noting too. While overall cancer risk wasn't increased, breast cancer was the most common malignancy at 7.1%. Importantly, this wasn't directly tied to morphia.

SPEAKER_01 1:58

Clinicians will likely find the treatment data compelling. Methotrexate, the most commonly used systemic drug, benefited 64% of patients. Phototherapy, particularly UVA1, was highly effective, with 78% of treated patients reporting improvement.

SPEAKER_00 2:16

Indeed, systemic treatments were primarily used for severe subtypes like linear or deep morphia, while topical therapies, most commonly high potency glucocorticoids, remain crucial for milder cases.

SPEAKER_01 2:29

The study's retrospective nature limits its ability to capture consistent long-term outcomes. Additionally, lacking a comparison to general population cancer risk leaves questions about malignancy associations.

SPEAKER_00 2:42

Even so, its strength lies in thorough, consistent clinical data. By focusing on one centre, the authors achieved detailed analysis using standardized diagnostic criteria, enabling valuable reflections on real-world care.

SPEAKER_01 2:57

Overall, the study highlights morphia as not merely a skin condition, but one often intertwined with other autoimmune conditions, demanding tailored care. Methotrexate, phototherapy, and vigilance for comorbidities are key takeaways for dermatologists.

SPEAKER_00 3:14

Agreed. That's all for today. Thanks for tuning in to BJD Talks. Until next time, stay curious and keep making strides in dermatology.