Treatment
Scleroderma
There is no single cure for scleroderma, and treatment varies based on the affected organs, the severity of the condition, and patient preferences. Common treatments include:
Medications
- Immunosuppressants: Mycophenolate mofetil, methotrexate, and cyclophosphamide help reduce immune system activity.
- Glucocorticoids: Reduce inflammation but can have serious side effects.
- NSAIDs: Relieves joint and tendon inflammation.
- Diuretics: Help reduce swelling by promoting urine production.
- Heartburn Medications: Omeprazole and related drugs alleviate heartburn.
- Pulmonary Hypertension Medications: Bosentan, sildenafil, and other drugs improve symptoms.
- ACE Inhibitors: Manage high blood pressure and kidney disease.
- Calcium-Channel Blockers: Improve Raynaud’s phenomenon symptoms.
Therapies
- Physical Therapy and Exercise: Maintain muscle flexibility and joint mobility.
- Skin Care: Regular moisturizing to keep skin supple and relieve itching.
- Occupational Therapy: Adaptations to assist with daily activities.
Lifestyle Changes
- Warm Clothing: To manage Raynaud’s phenomenon.
- Healthy Diet and Exercise: Control blood pressure and improve circulation.
- Smoking Cessation: Essential to improve blood circulation and overall health.
Surgical Interventions
- Skin Grafts and Flaps: To replace scarred skin and improve function.
- Laser Therapy and Photodynamic Therapy: Emerging treatments for skin symptoms.
Treating Scleroderma
Due to its rarity, the best treatment for scleroedema is not well established. Some reported benefits include:
- PUVA (psoralen and ultraviolet A) therapy
- Cyclophosphamide
- Oral corticosteroids
- Ciclosporin
- UVA1 phototherapy
- Electron beam radiation
Complications
Potential Complications of Scleroderma
Scleroderma complications can range from mild to severe and include:
- Fingertips: Severe Raynaud’s phenomenon can cause tissue damage and ulcers.
- Lungs: Scarring leads to breathing difficulties and decreased exercise tolerance.
- Kidneys: Scleroderma renal crisis causes rapid kidney failure.
- Heart: Increased risk of heart failure and irregular heartbeats.
- Teeth: Tightening facial skin makes oral hygiene challenging, increasing the risk of dental decay.
- Digestive System: Heartburn, difficulty swallowing, and other gastrointestinal issues.
- Joints: Tight skin over joints restricts movement.
Prognosis
While many people with scleroderma live long lives, the disease can increase mortality rates, especially in diffuse disease and pulmonary hypertension cases. Advances in treatments are improving longevity, but predicting individual outcomes remains challenging due to the disease’s variability.
References
- DermNet NZ. (n.d.). Scleroderma. Retrieved from https://dermnetnz.org/topics/scleroderma
- Stanford Health Care. (n.d.). Scleroderma. Retrieved from https://stanfordhealthcare.org/medical-conditions/skin-hair-and-nails/scleroderma.html
- Harvard Health Publishing. (n.d.). Scleroderma. Retrieved from https://www.health.harvard.edu/a_to_z/scleroderma-a-to-z
- Mayo Clinic. (n.d.). Scleroderma: Overview. Retrieved from https://www.mayoclinic.org/diseases-conditions/scleroderma/symptoms-causes/syc-20351952
- NHS. (n.d.). Scleroderma. Retrieved from https://www.nhs.uk/conditions/scleroderma/