SCLERODERMA

What is Scleroderma?

Scleroderma is a disease which primarily affects the skin producing abnormal hardening of tissues.

The exact cause of scleroderma is unknown, however, it is termed as an autoimmune disease, which triggers overproduction of collagen in tissues and damages blood vessels.

Collagen is a protein found in connective tissues of skin, joints, tendons and internal organs such as lungs, heart, liver, kidneys, etc. Hence the severity of disease depends on which parts of the body are affected.

Overproduction of collagen leads to hardening of the affected parts thereby hampering the normal functioning of that affected organ or part.

Types of scleroderma:

Scleroderma can be classified into Localized and Systemic scleroderma.

Localized scleroderma has two types namely Morphea and Linear scleroderma. Systemic scleroderma is further classified into diffuse and limited scleroderma.

01 Localized scleroderma:

This form of scleroderma usually affects skin but it may spread to muscles and bones. It usually affects the skin of hands and face causing hardening of the skin, the hard skin patches are discolored in appearance.

This is termed as a mild form of scleroderma where internal organs are not affected. Rarely localized scleroderma develops into systemic (generalized) scleroderma.

a Morphea: It is a form of localized scleroderma where waxy patches appear on skin which varies in size and color. Thickened skin is noticed under these patches. This form is more often seen in young adults.

b Linear scleroderma: It is a form of localized scleroderma most commonly seen in children. It shows up as a line or streak of hardened waxy skin on single parts of the body such as arm or leg or on forehead. It also affects the mobility of joints underneath the skin, which is affected and retards the growth of the affected parts in children.

02 Systemic scleroderma:

Systemic scleroderma is also known as systemic sclerosis as it affects more than one system of the body such as muscles, lungs, heart, liver, kidneys and gastrointestinal tract. It is termed as an autoimmune connective tissue disorder where connective tissues of different organs are affected becoming hard and functioning less than normal.

In diffuse scleroderma skin thickening happens rapidly and involves larger area whereas in limited scleroderma skin thickening is confined to lesser areas as fingers, hands and face and develops slowly over the years.

Symptoms of scleroderma:

• Raynaud’s phenomenon: One of the earliest signs of scleroderma may be an exaggerated response to cold temperatures or emotional distress. Such a response may lead to constriction of the blood vessels of fingers and toes, sometimes ear, nose and tip of tongue. This constriction of blood vessels causes color changes in skin to white or blue. It is sometimes painful.
• Swelling of fingers is another earlier sign seen in scleroderma. It is most commonly seen in morning due to inactivity at night.
• Pain and stiffness of joints: Pain, stiffness, swelling and warmth over the joints are commonly seen accompanying with muscle pain and weakness. Joint contractures are also noticed in few cases where the joints become fixed in flexed position and a movement becomes very painful. In few cases muscle weakness leads to carpal tunnel syndrome.
• Skin thickening or hardening with itching.
• Ulceration :It is most commonly seen over the fingertips. These ulcerations are difficult to heal due to poor circulation. Ulceration is caused due to excessive dryness of skin. Ulcerations must be treated with immediate effect as it may lead to infections, which becomes more difficult to treat.
• Calcium deposits can be seen just below the skin in the forms of lumps. These lumps breaks to be seen as chalky white material and is prone to infections.
• Telangiectasia: This is one of the specific sign of scleroderma where blood vessels near the surface of skin becomes visible as small red spots. Common places are fingers, palms, face and lips. This spots have a tendency to disappear on applying pressure but returns once the pressure is released.
• Sweat pores decrease on affected parts.
• There may be decrease in hair on affected parts.
• Sometimes the affected parts looks like tanned skin due to pigmentation.
• Acid reflux and swallowing difficulties are common in many patients.
• Dryness in eyes or mouth is due to decrease in secretion of salivary and tear glands.
• Skin hardening over the face may result into difficulty in opening the mouth thereby difficulty in maintaining dental hygiene.
• In severe cases lungs and kidneys are affected.
• Mild to severe Fatigue. Limiting your activities will help immensely.
• High blood pressure.
• Emotionally patients of scleroderma may feel shock, fear, anger, helplessness, guilt, etc. Professional counseling is helpful for the person suffering from scleroderma and his or her family to cope with scleroderma.

Diagnosis:

There is no single diagnostic test for scleroderma. However, an experienced doctor can diagnose this condition by taking thorough past and present medical history and through clinical examination.

ANA (Anti Nuclear Antibodies) a blood test helps to differentiate in types of scleroderma.

While diagnosing scleroderma it is important to determine the extent and severity of the disease to chalk out the treatment plan accordingly.

Treatment for Scleroderma:

Early diagnosis and timely treatment can help long-term management of scleroderma; whereby irreversible damage could be avoided. Earlier the better.

There is no complete cure for scleroderma as on now. However, that does not mean that there is no hope. Scleroderma needs to be controlled and kept under check. Also, some of the symptoms of Scleroderma can be very well reduced with medicines.

Developing an individualized treatment plan is desirable in most of the cases of scleroderma based on the symptoms.

Scleroderma is a disease affecting many organs at a time and showing variable symptoms from patient to patient thus the treatment plan must be holistic and individualistic based on the individual patient with major focus on the affected organ.

The treatment is aimed at improving the quality of life by reducing the symptoms like pain, improving nutrition and considering emotional aspect of disease fear, depression and social withdrawal caused by disfigurement.

Conventional medicines for scleroderma:

Symptomatic relief is achieved with conventional treatment.

Some important tips:

• Skin thickening is treated with drugs like D- penicillamine, interferon or cyclophosphamide.
• Raynaud’s phenomenon is treated with vasodilators such as calcium channel blockers.
• If a person develops ulcers it is treated with phosphodiesterase.
• The cases with hypertension is treated with anti hypertensives medicines.
• Acid reflux is treated with antacids.
• Corticosteroids are prescribed in the cases affecting lungs or kidneys.
• Patients suffering from scleroderma are always advised to keep their extremities warm by covering with gloves and socks. Particular care must be taken while exposure to cold weather, in air conditioner or while opening refrigerator.
• It is advisable to avoid emotional stress.
• At the time of such an episode, the patient may take warm bath or use room heaters to tackle the episode. Rubbing or massaging the hands and feet helps in restoring the blood circulation.
• Tobacco can affect the blood vessels badly in this condition. Smoking is strictly prohibited as it may increase or initiate Raynaud’s phenomenon.
• Excessive bathing or hand wash should be avoided.
• Keeping skin moisturized all the time is helpful.

Homeopathic treatment for scleroderma:

Scleroderma is a disease of connective tissues and it is governed by genetic an immunological factors. Homeopathy works at immunological level and the medicines are decided on the basis of patient’s genetic tendencies leading to this disease.

Homeopathic treatment is effective for scleroderma especially as a supportive measure to control the disease process and for getting some relief in some of the stubborn symptoms such as Raynaud’s phenomenon, painfulness, etc.