Treatment of pediatric localized scleroderma with methotrexate.

Objective: To analyze the effectiveness of methotrexate (MTX) for the therapy of pediatric localized scleroderma (LS).

Methods: A retrospective chart review was performed for 17 pediatric patients with LS who failed topical therapy and were subsequently treated with MTX (12.5-25 mg weekly) with or without oral corticosteroids.

Sjögren syndrome in a child: favorable response of the arthritis to TNFalpha blockade.

Tumor necrosis factor alpha (TNFalpha) blockade has recently been found to be ineffective in treating glandular and extraglandular manifestations of adult Sjögren syndrome (SS), including arthralgia and arthritis. We report a girl who developed purpura, polyarthritis, uveitis, and severe dental caries in the first year of life and optic neuritis by age three. SS was diagnosed at 11 years of age, when severe hypokalemic renal tubular acidosis developed during infliximab treatment for arthritis.

Methotrexate used as a steroid-sparing agent in non-renal chronic Henoch-Schönlein purpura.

Henoch-Schönlein purpura (HSP) is the most common form of systemic vasculitis in childhood and a small percentage of children develop a chronic form of the disease that often requires prolonged corticosteroid therapy. A detailed case description of a child with non-renal chronic HSP treated with methotrexate to allow for tapering of corticosteroids is presented. This represents the first report of methotrexate use in the treatment of chronic HSP.