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Sclerosing skin disorders in association with multiple sclerosis. Coincidence, underlying autoimmune pathology, or interferon induced?
  1. Thomas Hügle (hueglet{at}uhbs.ch)
  1. Department of Rheumatology, Basle University, Felix Platter Spital, Basel, Switzerland
    1. Stephanie Gratzl (s.gratzl{at}hin.ch)
    1. Department of Rheumatology, Basle University, Felix Platter Spital, Basel, Switzerland
      1. Thomas Daikeler (daikelert{at}uhbs.ch)
      1. Department of Rheumatology, Basle University, Felix Platter Spital, Basel, Switzerland
        1. Dieter Frey (dieter.frey{at}hin.ch)
        1. Department of Rheumatology, Basle University, Felix Platter Spital, Basel, Switzerland
          1. Alan Tyndall (alan.tyndall{at}fps-basel.ch)
          1. Department of Rheumatology, Basle University, Felix Platter Spital, Basel, Switzerland
            1. Ulrich A. Walker (ulrich.walker{at}fps-basel.ch)
            1. Department of Rheumatology, Basle University, Felix Platter Spital, Basel, Switzerland

              Abstract

              Objectives: To describe and analyze the manifestation of sclerosing skin disorders in patients with multiple sclerosis (MS).

              Case reports: We describe three patients with relapsing-remitting MS who developed skin sclerosis while receiving interferon (IFN)-ß treatment and review nine further cases of systemic sclerosis (SSc) in MS from the literature. Of all 12 patients reported, eight had limited cutaneous SSc, three had diffuse cutaneous SSc, and one patient had an antisynthetase syndrome. Localized scleroderma such as morphea was not described. The mean age at diagnosis was 25.2 years for MS (range 12-51) and 38.3 years for SSc (range 16-66). Eleven patients developed SSc after the onset of MS and manifested with skin sclerosis after a mean of 14.9 years (range 1-45). In five patients IFN-ß was commenced before the development of skin sclerosis (mean 4.6 years, range 1-8 years). There was no relationship between the onset of skin sclerosis and MS activity. With the exception of one individual, all patients had ANA.

              Conclusion: Sclerosing skin disorders may develop in the course of MS. The relatively early age of SSc onset in MS patients suggests a genetic predisposition and / or an IFN-associated trigger.

              • Raynaud’s phenomenon
              • connective tissue disease
              • interferon
              • multiple sclerosis
              • systemic sclerosis

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