Scleroderma - CREST syndrome - Signs - Symptoms - Diagnosis - Treatment - Prognosis

Scleroderma is not curable it can be considerably controlled with treatment methods that are aimed at the various symptoms that ravage the patient’s body. In some patients, the treatment could be effective while in others it may not be so.

Blood pressure medications helps to control hypertension and safeguard the kidney

Immunosuppressants such as penicillamine, methotrexate and azathioprine can help to control an overactive immune system

Skin

Skin itching is often relieved by using emollients or lotions

Use oil - based creams after bath to avoid dryness

Avoid using strong chemicals or soaps

Dryness and skin stiffness can be countered by using humidifiers in the interiors

Colchicine is administered to treat the inflammation that accompanies calcinosis

Raynaud’s phenomenon

For patients with finger tip ulceration, or clotting, low dose aspirin is administered

Ulceration of fingers will need topical or oral antibiotics

Topical nitroglycerine can be applied to areas that are highly-affected

Hand warming and hand protection can be applied to those with mild Raynaud’s phenomenon

Finger splints can be used to protect tender tissues

Medications such as Nifedipine and Nicardipine, that help to widen the arteries, are used for those with moderate Raynaud’s phenomenon

In severe cases, a digital sympathectomy may be done to stimulate the constricted blood vessels

GI tract

Heartburn can be contained with Omeprazole or antacids.

Elevating the head of the bed can also be a good idea to prevent back flow of acid into the esophagus

If bacteria causes diarrhoea, cramping and constipation, it can be treated with Tetracycline or Erthyromycin

Avoid excessive caffeine

Avoid smoking

Telangiectasia

Laser therapy is used to treat telangiectasia

Sun exposure must be minimized

Sun protection measures need to be taken

Lungs

Increased hypertension of the arteries supplying the lungs can be treated with calcium antagonists medications like Nifidipine and other anti coagulation drugs

Severe pulmonary hypertension can be treated by the intravenous supply of Prostacyclin or by the oral administration of Bosentan

Alveolitis or inflammation of the lung can be treated with immunosuppresants

Bone/Joint

Lifestyle modifications that eases the pressure from the joints while doing daily tasks must be undertaken

Exercises such as swimming or stretching exercises can be very effective

Anti inflammatories - can be administered to minimize swelling

Renal crisis

Stabilizing blood pressure is the main agenda in managing renal crisis that is associated with scleroderma

Some of the medications towards this end include ACE inhibitors, intravenous prostacyclin and calcium channel blocker,

Short term hemo dialysis can also be carried out

Depression

Depression in scleroderma patients is common. This can be treated by using anti-depressants like Prozac

Mouth

Mouth often gets dry due to the tight facial skin. Great care has to be taken to avoid tooth decay and other mouth problems. Consult a dentist for optimum advise

Cosmetic

Scleroderma results in skin scarring and some people would like to use cosmetic procedures, such as laser treatment or plastic surgery to enhance their looks.