Understanding Scleroderma -- Diagnosis and Treatment
How Do I Know If I Have Scleroderma?
Scleroderma is often hard to diagnose, since it may look like many other diseases. Your doctor will do a physical exam and take your medical history. He or she will look for changes in skin thickness and do some tests.
One test that doctors use is the nail-fold capillary test. This focuses on one of the earliest signs of scleroderma: the disappearance of tiny blood vessels in the skin of the hands and feet. Doctors also check the blood for specific signs. Your doctor may remove a small tissue sample (biopsy) for testing to help in the diagnosis of scleroderma.
What Is the Treatment for Scleroderma?
There is no cure for scleroderma. Treatment focuses on relieving symptoms and reducing the risk of complications.
Medications for Scleroderma
Localized skin changes may be treated with moisturizers or corticosteroid creams, but they often don’t help much.
Vasodilators, medicines that relax and open the blood vessels, may be prescribed to relieve Raynaud's phenomenon, a common symptom of scleroderma caused by the spasm of blood vessels in the hands and feet. Avoiding cold temperatures also helps reduce this symptom.
Drugs called angiotensin-converting enzyme (ACE) inhibitors and other blood pressure medications may be used to control blood pressure and help prevent serious kidney complications.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen, and ibuprofen, may help joint pain. Corticosteroid pills, such as prednisone, may be used to lower inflammation.
Indigestion can occur when scleroderma affects the esophagus, stomach, or intestines. It can be treated with drugs that decrease stomach acidity and help move food through the stomach and intestines. Your doctor may suggest antibiotics, a special diet, and medications to help your digestion.
Drugs that suppress the immune system, like mycophenolate, cyclophosphamide, and methotrexate, may help some people, none are approved for treatment of scleroderma.
Physical Therapy for Scleroderma
Stretching and physical therapy may help keep joints from becoming bent or contracted. Raynaud's phenomenon can be helped by staying warm and wearing gloves and warm socks.
Rarely, orthopedic surgery on the hands may be necessary to correct severe joint contractures, skin deformities, or scars.