Neurological and psychological aspects of scleroderma of the face and neck in children

Abstract

In the structure of morbidity, among rheumatic diseases in children, juvenile scleroderma takes the third place in frequency after juvenile idiopathic arthritis and systemic lupus erythematosus. Timely diagnosis of juvenile scleroderma presents certain difficulties, since the traditional criteria for making a diagnosis of scleroderma are applicable to adult patients. Unlike adult patients, in the initial period of the disease, lesions of the internal organs are less likely to occur, and joint damage occurs with equal frequency. According to recent studies, the most common neurological manifestations in juvenile scleroderma with localization of lesions on the head and neck are epileptic seizures, headaches, local neurological deficits, psychoemotional and cognitive impairments. In the course of this study, 51 children with scleroderma with localization of lesions on the head and neck at the age of 3 to 17 years were examined. In most patients (80%), the first symptom of the disease was a characteristic skin lesion in the form of a purple spot, followed by linear tissue induction, less often the disease began with the appearance of an alopecia on the scalp or in the eyebrow area. Scleroderma with lesions on the head and neck is the most severe form of all localized types of scleroderma and can be equated in its severity with its generalized forms. The palette of polysystemic disorders in this form requires a multidisciplinary approach in examination and therapy. The list of mandatory examination methods for scleroderma of the face and neck should include brain MRI, EEG and psychological examination.

Keywords

• scleroderma of the face and neck
• children
• psychological state
• neurological disorders