METABOLIC RISK FACTORS FOR DISORDERS IN LOCALIZED SCLERODERMA

Authors:

Abstract:

Localized scleroderma is a relatively common chronic inflammatory connective tissue disorder, yet the mechanisms underlying its progression remain insufficiently understood, underscoring the need to investigate metabolic risk factors and develop appropriate therapeutic approaches. In this study, a comprehensive examination and treatment were performed in 78 patients with localized scleroderma, including assessment of endothelial function, endogenous intoxication, and prooxidant–antioxidant balance, as well as comparison of the efficacy of standard and proposed therapies. It was demonstrated that patients with focal scleroderma develop an unfavorable toxic-metabolic profile. Based on the obtained results, an improved comprehensive treatment method was developed: in addition to standard therapy, patients in the main group received an endothelial-protective agent, a sorbent, an antioxidant agent, and ultrasound-mediated hyaluronidase (ultraphonophoresis). The proposed treatment regimen led to significant reductions in endothelin-1, VEGF-A, VCAM-1, and protein carbonyl levels, along with increased activity of superoxide dismutase, glutathione reductase, and increased reduced glutathione content. These findings support the rationale for incorporating endothelial-protective and antioxidant agents into comprehensive treatment schemes to enhance current therapeutic approaches and optimize patient management.

Keywords:

localized scleroderma risk factors metabolic disorders oxidative stress morphea

References:

1. Albuquerque JV, Andriolo BN, Vasconcellos MR, Civile VT, Lyddiatt A, Trevisani VF. Interventions for morphea. Cochrane Database of Systematic Reviews. 2019;7:CD005027. doi:10.1002/14651858.CD005027.pub4.
2. Bali G, Szilvási A, Inotai D. Comorbidity of localized scleroderma and primary biliary cholangitis. Journal der Deutschen Dermatologischen Gesellschaft. 2018;16(11):1323–1327. doi:10.1111/ddg.13731.
3. Distler O, Cozzio A. Systemic sclerosis and localized scleroderma: current concepts and novel targets for therapy. Seminars in Immunopathology. 2016;38(1):87–95. doi:10.1007/s00281-015-0520-3.
4. George R, George A, Kumar TS. Update on management of morphea (localized scleroderma) in children. Indian Dermatology Online Journal. 2020;11(2):135–145. doi:10.4103/idoj.IDOJ_266_19.
5. Gambichler T, Schmitz L. Ultraviolet A1 phototherapy for fibrosing conditions. Frontiers in Medicine. 2018;5:237. doi:10.3389/fmed.2018.00237.
6. Kalampokis I, Yi BY, Smidt AC. Abatacept in the treatment of localized scleroderma: a pediatric case series and systematic literature review. Seminars in Arthritis and Rheumatism. 2020;50(4):645–656. doi:10.1016/j.semarthrit.2020.05.005.
7. Miyagawa T, Ichimura Y, Nakamura K. Progranulin overproduction contributes to fibrosis in localized scleroderma. Journal of Dermatological Science. 2018;92(2):207–214. doi:10.1016/j.jdermsci.2018.08.005.
8. Rongioletti F, Ferreli C, Atzori L, Bottoni U, Soda G. Scleroderma: clinico-pathological correlations. Giornale Italiano di Dermatologia e Venereologia. 2018;153(2):208–215. doi:10.23736/S0392-0488.18.05922-9.
9. Shenavandeha S, Eskandar TT, Nazarinia KSM. Serum vascular endothelial growth factor in systemic sclerosis patients. The Egyptian Rheumatologist. 2017;39(1):19–24. doi:10.1016/j.ejr.2016.06.003.
10. Vasquez RA, Sendejo CB, Jacobe H. Morphea and other localized forms of scleroderma. Current Opinion in Rheumatology. 2012;24(6):685–693. doi:10.1097/BOR.0b013e32835896ce.
11. Wang Y, Shan JL, Chen HY, Wu ZF. Comparison of shear wave elastography with clinical score in localized scleroderma. Dermatology. 2018;234(3–4):147–153. doi:10.1159/000491703.
12. Zulian F, Culpo R, Sperotto F. Consensus-based recommendations for the management of juvenile localized scleroderma. Annals of the Rheumatic Diseases. 2019;78(8):1019–1024. doi:10.1136/annrheumdis-2018-214697.

Publication:

«World of Medicine and Biology» Vol. 22 No. 1 (2026) , с. 17-22
УДК 616.5-004.1.

DOI:

https://doi.org/10.26724/2079-8334-2026-1-95-17-22