An Approach to the Treatment of Scleroderma PDF Print E-mail
Wednesday, 03 April 2013 22:30
Systemic sclerosis is unique among the rheumatic diseases because it presents the challenge of managing a chronic multisystem autoimmune disease with a widespread obliterative vasculopathy of small arteries that is associated with varying degrees of tissue fibrosis.

The hallmark of Scleroderma is clinical heterogeneity with subsets that vary in the degree of disease expression, organ involvement, and ultimate prognosis. Thus, the term Scleroderma is used to describe patients who have common manifestations that link them together, whereas a highly variable clinical course exists that spans from mild and subtle findings to aggressive, life-threatening multisystem disease.

The physician needs to carefully characterize each patient to understand the specific manifestations and level of disease activity to decide appropriate treatment. This is particularly important in treating a patient with Scleroderma because there is no treatment that has been proven to modify the overall disease course, although therapy that targets specific organ involvement early before irreversible damage occurs improves both quality of life and survival.

This review describes our approach as defined by evidence, expert opinion, and our experience treating patients.

Scleroderma is a multisystem disease with variable expression; thus, any treatment plan must be holistic, yet at the same time focus on the dominant organ disease. The goal of therapy is to improve quality of life by minimizing specific organ involvement and subsequent life-threatening disease. At the same time the many factors that alter daily function need to be addressed, including nutrition, pain, deconditioning, musculoskeletal disuse, comorbid conditions, and the emotional aspects of the disease, such as fear, depression, and the social withdrawal caused by disfigurement.

To read the full article, please download from the link below.

 
More articles :

» A Brief History of Scleroderma

While scleroderma may not be very well known to the average person, investigation reveals it has been around for a long time.Classical ReferencesCases of skin disease similar to scleroderma may be found in the writings of Hippocrates as far back as...

» Quality Indicator Set for Systemic Sclerosis

D. Khanna, O. Kowal-Bielecka, P.P. Khanna, A. Lapinska, S.M. Asch, N. Wenger, K.K. Brown, P. Clements, T. Getzug, M.D. Mayes, T.A. Medsger Jr., R. Oudiz, R. Simms, V. Steen, P. Maranian, D.E. FurstBackground:Systemic sclerosis (SSc) is associated...

» Genetics of Scleroderma: Implications For Personalized Medicine

Significant advances have been made in understanding the genetic basis of systemic sclerosis (scleroderma) in recent years. Can these discoveries lead to individualized monitoring and treatment? Besides robustly replicated genetic susceptibility...

» Scleroderma and Massage Therapy

In a recent patient group meeting, we had the immense pleasure and honour of sitting with Rinalda, a local massage therapist, to discuss the importance of massage therapy and how it can help with our Scleroderma.Rinalda noted that from the beginning...

» Rare T Follicular Helper Cells Could Hold Key To Treating Immune Disorders

The characterization of a rare immune cell’s involvement in antibody production and ability to ‘remember’ infectious agents could help to improve vaccination and lead to new treatments for immune disorders, say researchers from the .The cells,...

» Pulmonary Arterial Hypertension And Scleroderma

is a disease that affects the skin and internal organs. The literal meaning of the word is "hard skin"; people with Scleroderma experience a hardening and tightening of their skin. The inflammation and scarring associated with Scleroderma can cause...