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Assessment of activity of skin lesions

Clinical features: Appearance of new lesions, extension of existing plaques, warmth, lilac borders, skin induration and edema

LoSCAT, Physician's global assessment

Ultrasound (20 MHz)

Skin Biopsy

Clinical inactivity:

No erythema, no new or enlarging lesions in the last 3 months, no change in thickness, no worsening of joint contractures, PGA. Visual analog scale of 0, no active extracutaneous features

Assessment of extracutaneous involvement

Skeletal X rays- linear scleroderma involving limbs, special attention to the affected joints

Lesions affecting scalp and face

MRI brain

Ophthalmic evaluation

Orthodontist/maxillofacial surgeon

Focused systemic evaluation in patients with pansclerotic morphea