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Disabling pansclerotic morphea (PM) of childhood is a rare and debilitating variant of localized scleroderma. We describe a 4-year-old girl with rapid progression of deep cutaneous fibrosis extending into the muscle fascia with disabling joint contractures of the hips, knees, ankles, and fingers and recalcitrant ischemic ulcerations. Within the first months of therapy with dual oral endothelin receptor antagonist bosentan (31.25 mg qd for 4 weeks [DOSAGE ERROR CORRECTED], then 31.25 mg bid) limb ulcers improved, with resolution of the widespread sclerotic skin lesions. Joint mobility improved, and a substantial decrease of skin thickness was noted. No side effects were noted. In the context of other data in scleroderma, bosentan may be a promising option in the treatment of PM.

Verbal material used to assess the cognitive abilities of Spanish-speakers in the the United States is frequently of linguistically unacceptable quality. The use of these materials in research settings is thought to pose a serious threat to test validity and hence to the validity of claimed results or conclusions. The authors explain how and why incorrect language finds its way into cognitive tests used in research and other settings and suggest solutions to this serious problem.