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and (5) mixed morphea, a combination of 2 or more of above subtypes. Bullous morphea was not included in the Padua proposed classification categories; this form involves formation of bullae, usually with ulceration of the skin, and extensive scarring and sclerodermatous changes. Early exit points from the survey were provided for CARRA members who did not use systemic immunosuppressive medications, had limited experience treating these patients, or otherwise wished to exit the survey. The survey format consisted of multiple-choice questions and questions in which PR were asked to rank features. All questions provided an option to write in a response. Members were also provided with clinical vignettes and asked to describe their treatment strategy for the presented patients. E-mail reminders were sent to obtain an overall response rate of at least 80% to ensure generalizability of the responses. When respondents listed a range of doses or durations, the average of the specified range was used. Descriptive statistics, including means, medians, and standard deviations, were calculated. For each disease feature a mean score was calculated by averaging the ranks. RESULTS Survey respondents. A total of 158 PR took the survey, representing 81% of the CARRA pediatric rheumatology membership. The respondents consisted of 114 board-certified or senior PR (81.4% of all CARRA board-certified/senior PR; 109 board-certified PR with average year of board certification 1995, median 1994; 5 senior PR), 15 board-eligible PR (79% of all CARRA board-eligible PR), and 29 fellows (81% of all CARRA fellow members). The respondents came from a minimum of 71 different sites (18 responses were anonymous so that we could not identify responder’s site), including all 28 pediatric rheumatology training programs in the United States and Canada; this represents 88% of the total 81 CARRA sites. There was a median of 2 respondents per site (range 1–6). The respondents reported treating a total of 1041 patients with LS in the prior year, of whom 757 received systemic medications during the prior year. As these patient numbers may overestimate the LS population if patients are shared among the PR at a given site, we also calculated a “minimum” total patient number where we counted only 1 PR’s patient count per site unless it was certain that duplication at a site did not exist. The patient numbers from the 18 anonymous survey respondents were excluded from this minimum count because their site affiliation was unknown. This yielded a minimum total of 666 patients with LS seen in the prior year, a median of 7.5 patients with LS at each site (range 0–86). The minimum number of patients with LS on systemic medications was 476 in the prior year, a median of 5 patients on systemic medications at each site (range 0–73). A total of 33 respondents chose 1 of the 2 survey early exit points, either because they had never used systemic medications to treat LS (3 fellows, 1 board-eligible and 4 board-certified PR), because they did not treat patients with LS, or for other reasons. These 33 PR included 17 board-certified or senior PR, 4 board-eligible PR, and 12 fellows, and came from 19 sites (there were 3 anonymous respondents whose site we did not know). Overall, 125 PR continued with the survey. The group that chose to exit the survey early had fewer experienced clinicians than the group that continued with the survey. Forty-eight percent of the early exit respondents had just finished training (board-eligible) or were still in fellowship, compared to 25% of those who continued with the survey. Moreover, the PR who chose to exit early saw fewer patients with LS in the prior year (median 2 patients) than
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