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Understanding Scleroderma -- Diagnosis and Treatment
How Do I Know If I Have Scleroderma?
Scleroderma is often difficult to diagnose, since it may look like many other diseases. Changes in skin thickness, the presence of specific antibodies in the blood, or early blood-vessel changes can be helpful in diagnosing the disease. Your doctor may remove a small tissue sample (biopsy) for analysis to help in the diagnosis of scleroderma. However, there is no single test that can tell for sure whether you have the disease.
One of the most useful indicators that doctors use is the nail-fold capillary test. This focuses on one of the earliest identifiable signs of scleroderma: the disappearance of tiny blood vessels in the skin of the hands and feet. The test involves examining skin at the base of the fingernail. While the test alone doesn't confirm scleroderma, when combined with several typical symptoms, it can aid the diagnosis. For a definitive diagnosis, your doctor must carefully analyze many test results, perform a physical exam, and take a complete medical history.
What Is the Treatment for Scleroderma?
There is no cure for scleroderma. Treatment focuses on relieving symptoms and reducing the risk of complications.
Medications
Localized skin changes may be treated with topical agents like moisturizers or corticosteroid medications. Ultraviolet light therapy (phototherapy) has also shown some benefit, but more research is needed.
Vasodilators, medicines that relax and open the blood vessels, may be prescribed to relieve Raynaud's phenomenon. Avoiding exposure to cold and sunlight is also helpful. Drugs called angiotensin-converting enzyme (ACE) inhibitors and other blood pressure medications may be used to control blood pressure and alleviate serious kidney complications.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen, and ibuprofen, may ease joint pain. Steroids, such as prednisone, may be used to decrease inflammation.
Indigestion can be treated with drugs that decrease stomach acidity and promote movement of food through the stomach and intestines. Your doctor may suggest antibiotics, a special diet, and medications to improve your ability to digest food.
D-penicillamine is thought to decrease the production of collagen and may delay the progression of the disease. Medications that suppress the immune system, like cyclophosphamide and methotrexate, may be helpful in some people.
Physical Therapy
Stretching and physical therapy may help keep joints and tissue strong and flexible. Raynaud's syndrome can be relieved somewhat by staying warm and wearing gloves and warm socks.
Rarely, orthopaedic surgery of the hands may be necessary to correct severe joint contractures, skin deformities, or scars.
WebMD Medical Reference
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