Lisa Arkin, MD: Raising Awareness About Scleroderma in the Dermatology World

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This interview with Dr. Arkin involved a discussion, in honor of June being National Scleroderma Awareness Month, of information on underlying causes and new research on the skin condition.

In this HCPLive interview, Lisa Arkin, MD, spoke about her experiences in the dermatology field treating patients with scleroderma, sharing her insights on the skin condition and its future.

Arkin is known for her work as a pediatric dermatologist and member of the Society for Pediatric Dermatology, University of Wisconsin School of Medicine & Public Health / American Family Children's Hospital.

“So scleroderma is sort of a big umbrella term that means hardened skin,” she explained. “And it has a whole different series of subtypes. So the first question is what subtype are we dealing with, because there is ‘systemic scleroderma’, which is more of a systemic autoimmune disease that can have multi-organ manifestations…and then there's localized scleroderma which is which is otherwise known as morphea.”

Among her key points, Arkin pointed out that both treatment and monitoring are quite different for the subtypes, so a correct diagnosis is vital. She added that there are really different consensus criteria around each, particularly for the more systemic forms.

“We think about autoantibody profiles helping to inform the subtype, whereas morphea, which is more skin-limited, really is a clinical diagnosis and there's not a lot of utility in checking autoantibody associations, because, again, the kind of monitoring and surveillance really is different,” Arkin said.

She added that when looking at the epidemiology, and for kids in particular, morphea is certainly more common than the systemic forms of scleroderma.

“The truth is, we still don't fully understand the root cause for either one, and like many auto inflammatory diseases, the working hypothesis is that there are patients who are genetically susceptible,” Arkin explained. “Who then, in the appropriate environmental exposure, develop 1 of these 2 subtypes. And we know there are autoantibody associations that really are intrinsic to rendering that diagnosis, and even the skin-limited form called morphea.”

Arkin also added that trauma is actually a common trigger for where these patches develop in the morphea subtype of the condition.

“And that's been validated in a number of studies,” she stated. “The systemic form is still really thought to be genetic susceptibility, but trying to disentangle all the really heterogeneous environmental exposures becomes very complicated because, like most autoimmune diseases, including lupus, or dermatomyositis, there's usually not a single trigger. It's sort of complex and multifactorial.”

For more information on scleroderma, view the full HCPLive interview segment above.

The quotes contained in this interview synopsis were edited for clarity.