Notice from Columbus Arthritis Center: At this time, only patients scheduled for biologic infusions should come in for their treatment unless they have signs or symptoms of infection or known exposure to anyone with the Coronavirus. Otherwise, any non-urgent/stable patients should not come into the office. We will call these patients on the day of their visit to provide recommendations. We are recommending that most patients continue treatment as long as they are doing well and do not show signs of infection. Please call us if you have any questions 614-486-5200.

Scleroderma

What is Scleroderma?

Scleroderma is a chronic autoimmune disease that was first described in the 18th century. The term scleroderma means “hard skin,” which describes thickening of the skin from increased deposits of collagen.

There are two types of scleroderma. Localized scleroderma affects the skin in limited areas and the musculoskeletal system. Systemic sclerosis causes more widespread skin changes and may be associated with internal organ damage in the lungs, heart and kidneys. It can cause arthritis, slow contractions in the gastrointestinal tract, muscle inflammation, dry eyes and dry mouth. Most people with scleroderma have cold-induced spasms of small blood vessels in their hands or feet, known as Raynaud’s phenomenon, which caused the fingers or toes to turn white or blue and may be painful.

Patient suffering from scleroderma on hands and wrists

Cause

 

In most cases, the cause of scleroderma is unknown. However, in a small minority of cases, scleroderma or scleroderma-like illnesses are associated with exposure to certain toxins or as a complication of bone marrow transplants. Scleroderma is not contagious and is rarely inherited.

Systemic sclerosis is associated with over-activation of the immune system, which normally functions to protect the body against cancers and invading infections. This causes damage to cells that line small blood vessels, which in turn leads to the over-production of scar tissue.

 

Diagnosis


Diagnosis of scleroderma is based on clinical history and physical findings. Diagnosis may be delayed in those without significant skin thickening. Laboratory, X-ray and pulmonary function tests determine the extent and severity of internal organ involvement.

Health Impact

 

  • Scleroderma affects women more than men and adults more than children.
  • 10-20 new cases are diagnosed per million people each year.
  • Five-year survival rate is 80 – 85 percent.
  • Lung, heart and kidney damage are the most frequent causes of severe disability and death.
  • Many people have decreased hand function because of joint disfigurement or finger ulcers.

Patient with spots from scleroderma on wrist and lower arm

Treatment

 

The severity of joint involvement and the degree of systemic symptoms vary greatly from one individual to another. Early, accurate diagnosis and therapy may minimize years of pain and disability.

Medical treatment consists of nonsteroidal anti-inflammatory medications. Indomethacin is most effective, while sulfasalazine may benefit those with more severe involvement. Peripheral joint arthritis may respond to methotrexate. Musculoskeletal pain may respond to nonsteroidal anti-inflammatory drugs.