Diagnostic and Treatment Strategies of Dermatologists for Treating Morphea in Hungary.

Localized scleroderma is an uncommon disease, only infrequently encountered by dermatologists in private practices or even in larger academic centers. Because of its rarity, current treatment guidelines are mostly based on low-level clinical evidence and expert opinions. The aim of this study was to evaluate treatment strategies to treat localized scleroderma. A questionnaire was developed and sent to dermatologists in Hungary. 101 returned questionnaires were eligible for evaluation. 87.12% of clinicians employed local steroids. Antibiotics were the most preferred systemic agents. Penicillin was used by 32.67% and doxycycline by 22.77% of dermatologists. Methotrexate was employed by only 6.93%. Borrelia serology was obtained by 80.19% of clinicians. More than half of practitioners performed extractable nuclear antigen (ENA) screening (53.46%). Most Hungarian dermatologists did not follow current treatment recommendations for morphea, a trend that likely holds true for other dermatology practices in the East-Central European region as well. Easily accessible, evidence-based guidelines are needed to improve patient care. Patients with localized scleroderma should be referred to specialized centers with more experience where high quality care can be ensured.