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There has been concern that measles, mumps and rubella (MMR) vaccination might increase disease activity in juvenile idiopathic arthritis (JIA). Now a retrospective study in Holland (Ann Rheum Dis 2007;66:1384–7) has shown no significant increase in flares of disease activity in the period of 6 months after booster MMR at age 8–10 years. [In Holland MMR is offered routinely at 14 months and at age 8–10 years.] Mean disease activity among 207 patients did not differ significantly in the 6 months before and the 6 months after booster vaccination and 40 flares occurred in 36 children prevaccination compared with 56 in 50 children post vaccination. There was no increase in use of methotrexate or steroids after the booster and no increase in disease activity among the 49 patients taking methotrexate. These researchers conclude that the majority of patients with JIA can be vaccinated safely with MMR. They call for a prospective study.
Scleroderma is rare in children. The main type is juvenile localised scleroderma (JLS) of which there are four subtypes: plaque morphoea, generalised morphoea, deep morphoea and linear scleroderma. Linear scleroderma of the face affects the frontoparietal region and is known as linear scleroderma “en coup de sabre” (ECDS). A trawl of 270 paediatric rheumatology and dermatology centres on six continents (Br J Ophthalmol 2007; …