Scleroderma is a group of diseases that cause skin, and sometimes internal organs, to become hard and tight. In fact, the word scleroderma actually means "hard skin." It happens when the body makes too much collagen, the protein that makes up connective tissues.
Localized scleroderma usually only affects the skin on the hands and face. Systemic scleroderma is more serious and affects connective tissue in many parts of your body, including internal organs.
Scleroderma is considered an autoimmune disease, meaning that the immune system mistakenly attacks the body's own tissues. According to the Scleroderma Foundation, about 300,000 people in the United States have the condition. It is more common in women than men.
Symptoms of scleroderma may include the following:
Morphea scleroderma: Oval patches of thick skin that are white in the middle and purple around the edges. They usually appear on the chest, back, and stomach, but can also be on arms and legs.
Linear scleroderma: Streaks of hardened skin that appear on arms, legs, or forehead.
Diffuse cutaneous systemic sclerosis: hardening of skin on fingers, hands, arms, legs, face, neck, and trunk. This type of scleroderma usually affects both sides of the body, meaning if you have problems with your left arm, you'll have problems with your right arm, too. It also can affect internal organs, including heart, lungs, kidneys, and esophagus.
Limited cutaneous systemic sclerosis: Affects skin on fingers, lower arms and legs, face, and neck. People with this type of scleroderma often have CREST syndrome. The term CREST stands for:
Sine scleroderma: Affects internal organs, but not skin
Seizures and headaches
Doctors believe scleroderma is caused by the immune system mistakenly attacking the body's own tissues. The immune system attack causes inflammation and triggers the body to make too much collagen. Excess collagen causes the skin, and sometimes the internal organs, to become hard and tight. Researchers are not sure what triggers this autoimmune response. Both genetics and environment may play a role.
These factors may increase the risk of scleroderma:
It is not always easy to diagnose scleroderma. You may need to see both a rheumatologist (arthritis specialist) and a dermatologist (skin specialist). The doctor will do a physical examination and feel your skin to check for thickened and hardened areas. The doctor may also press affected tendons and joints and do the following:
Many early scleroderma symptoms are like those of other connective-tissue diseases, such as rheumatoid arthritis, lupus, and polymyositis. When someone has more than one of these diseases, it is called mixed connective-tissue disease.
Although no one knows how to prevent scleroderma, you can take steps to avoid getting infections when you have scleroderma. Your doctor may recommend:
There is no cure for scleroderma. Medications can treat symptoms and prevent complications. Making changes to your lifestyle and diet can make living with the disease easier.
These simple steps may help improve quality of life:
Doctors often treat localized scleroderma with moisturizers or steroid creams. Oral medications, such as minocycline (Minocin or Dynacin), may also be used to stop localized scleroderma from getting worse if it involves a large area of the body, such as an entire arm or leg.
Systemic scleroderma may be treated with medications that improve circulation, reduce heartburn, preserve kidney function, and control high blood pressure. Some medications a doctor may prescribe for scleroderma include:
Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs to relieve joint pain and inflammation.
Medications to promote better circulation: can help prevent high blood pressure and reduce symptoms of scleroderma. They include:
Disease-modifying antirheumatic drugs (DMARDs): DMARDs slow the progression of the disease. They include:
Immunosuppressants: Suppress an overactive immune system. These drugs can have serious side effects including kidney damage and increased risk of infection. They include:
Antacids: To reduce heartburn when there is damage to the esophagus.
When symptoms of scleroderma become very severe, doctors may recommend the following procedures:
People with scleroderma may not get enough vitamins and minerals in their diet, especially if there is damage to their digestive system. Your doctor may suggest you take a supplement. Always tell your doctor about the herbs and supplements you are using or considering using.
These general nutritional tips are good for your overall health, especially if you have a long-lasting disease:
Your doctor may recommend taking a multivitamin daily that has the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
These supplements may help reduce some symptoms:
Herbs may strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting treatment.
Few studies have examined the use of herbs to treat scleroderma. Ask your doctor before taking herbs or supplements.
A few studies suggest that acupuncture may improve blood flow in the hands and fingers, help heal fingertip ulcers, and may reduce the formation of fibrous tissue. It may also relieve pain.
Research suggests that massage may help improve circulation. More research is needed to know whether massage works for scleroderma.
Biofeedback may help some people with scleroderma better control the temperature in their hands and feet, although studies are mixed. Other mind-body techniques such as counseling, meditation, and emotional freedom technique (EFT) may also help.
In some people, symptoms develop quickly for the first few years and continue to get worse. However, in most people, the disease gets worse slowly, over time.
People who have only skin symptoms have a better outlook. Widespread (systemic) scleroderma can lead to:
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Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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