HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Suggest Treatment For Scleroderma

default
Posted on Thu, 13 Nov 2014
Question: I have been diagnosed with Scleroderma and I cannot get anything for relief of the pain or itching Looking for another Provider in XXXXXXX or Fort Myers area, any suggestions
doctor
Answered by Dr. Shafi Ullah Khan (1 hour later)
Brief Answer:
Neds management, and rheumatologists listed

Detailed Answer:
Thank you for asking

Scleroderma is derived from the Greek words skleros (hard or indurated) and derma (skin) and it is used to describe a disease characterized by progressive skin hardening and induration. Hippocrates first described this condition as thickened skin.

Now their resilience depends on their etiology which are following.

Silica exposure
Solvent exposure (vinyl chloride, trichloroethylene, epoxy resins, benzene, carbon tetrachloride)
Radiation exposure or radiotherapy
Cytomegalovirus, human herpesvirus 5, and parvovirus B19 have been proposed as viral accelerating factors.

maintain your core body temperature; i strongly insist smoking cessation in case you smoke, and avoid exposure to cigarette smoke. Also avoid digital or skin trauma and prolonged cold exposure.

For itching aspect fo scleroderma you need

Moisturizers
Histamine 1 (H1) and histamine 2 (H2) blockers
Tricyclic antidepressants
Trazodone

For raynaurd phenomenon or digital troubles

Calcium channel blockers (increasing the dose to tolerance)
Prazosin
Prostaglandin derivatives (eg, prostaglandin E1)
Dipyridamole
Aspirin
Topical nitrates

If your stomach is involved following options are available.
Antacids
Histamine 2 (H2) blockers
Reflux and aspiration precautions
Proton pump inhibitors
Prokinetic agents
Octreotide
Stool softeners
Laxatives

If lungs are involved following options are there.

Prostaglandin derivatives such as epoprostenol, treprostinil, beraprost, and iloprost
Phosphodiesterase type 5 (PDE-5) inhibitors such as sildenafil and tadalafil
Endothelin receptor antagonists such as bosentan, ambrisentan and macitentan

Surgical Options

Digital sympathectomy and botulinum toxin injections may be used if severe Raynaud phenomenon having an unrelenting acute attack and threatened by digital loss. Many ulcers require management by a wound care specialist. Debridement or amputation may be required in severe ischemic or infected digital lesions. Digital sympathectomy may be indicated in severe cases.

Hand surgery may be performed to correct severe flexion contractures.

Removal of severely painful, draining or infected calcinotic deposits is occasionally required.

Surgical fundoplication may be required to treat severe esophageal reflux with complicating aspiration pneumonitis. Laser ablation or even gastric antrectomy may be required to control persistent bleeding caused by gastric antral vascular ectasia (GAVE).

Episodes of acute abdominal pain need to be evaluated with extreme care to avoid the misdiagnosis of an acute abdomen since occasionally patients with systemic sclerosis present with symptoms of acute abdomen that resolve with proper medical treatment and do not require surgical intervention (pseudo acute abdomen).

Vitamin deficiencies and malabsorption should be addressed in case with frequent or severe bacterial overgrowth
Large doses of vitamin C (>1000 mg/d) should be avoided because this stimulates collagen formation and may enhance fibrotic tissue deposition.

For further management visit a rheumatologist nearby. Here are some recommendations.

Dr. K R. XXXXXXX MD
3722 Central Ave Suite 2
Fort Myers, FL 33901

Dr. XXXXXXX XXXXXXX DO
1528 del Prado Blvd S
Cape Coral, FL 33990

Dr. XXXXXXX R. Baldinger, MD
13813 Metro Pkwy
Fort Myers, FL 33912

I hope it helps. take good care of yourself and dont forget to close the discussion please.

May the odds be ever in your favour.

Regards
Khan

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Suggest Treatment For Scleroderma

Brief Answer: Neds management, and rheumatologists listed Detailed Answer: Thank you for asking Scleroderma is derived from the Greek words skleros (hard or indurated) and derma (skin) and it is used to describe a disease characterized by progressive skin hardening and induration. Hippocrates first described this condition as thickened skin. Now their resilience depends on their etiology which are following. Silica exposure Solvent exposure (vinyl chloride, trichloroethylene, epoxy resins, benzene, carbon tetrachloride) Radiation exposure or radiotherapy Cytomegalovirus, human herpesvirus 5, and parvovirus B19 have been proposed as viral accelerating factors. maintain your core body temperature; i strongly insist smoking cessation in case you smoke, and avoid exposure to cigarette smoke. Also avoid digital or skin trauma and prolonged cold exposure. For itching aspect fo scleroderma you need Moisturizers Histamine 1 (H1) and histamine 2 (H2) blockers Tricyclic antidepressants Trazodone For raynaurd phenomenon or digital troubles Calcium channel blockers (increasing the dose to tolerance) Prazosin Prostaglandin derivatives (eg, prostaglandin E1) Dipyridamole Aspirin Topical nitrates If your stomach is involved following options are available. Antacids Histamine 2 (H2) blockers Reflux and aspiration precautions Proton pump inhibitors Prokinetic agents Octreotide Stool softeners Laxatives If lungs are involved following options are there. Prostaglandin derivatives such as epoprostenol, treprostinil, beraprost, and iloprost Phosphodiesterase type 5 (PDE-5) inhibitors such as sildenafil and tadalafil Endothelin receptor antagonists such as bosentan, ambrisentan and macitentan Surgical Options Digital sympathectomy and botulinum toxin injections may be used if severe Raynaud phenomenon having an unrelenting acute attack and threatened by digital loss. Many ulcers require management by a wound care specialist. Debridement or amputation may be required in severe ischemic or infected digital lesions. Digital sympathectomy may be indicated in severe cases. Hand surgery may be performed to correct severe flexion contractures. Removal of severely painful, draining or infected calcinotic deposits is occasionally required. Surgical fundoplication may be required to treat severe esophageal reflux with complicating aspiration pneumonitis. Laser ablation or even gastric antrectomy may be required to control persistent bleeding caused by gastric antral vascular ectasia (GAVE). Episodes of acute abdominal pain need to be evaluated with extreme care to avoid the misdiagnosis of an acute abdomen since occasionally patients with systemic sclerosis present with symptoms of acute abdomen that resolve with proper medical treatment and do not require surgical intervention (pseudo acute abdomen). Vitamin deficiencies and malabsorption should be addressed in case with frequent or severe bacterial overgrowth Large doses of vitamin C (>1000 mg/d) should be avoided because this stimulates collagen formation and may enhance fibrotic tissue deposition. For further management visit a rheumatologist nearby. Here are some recommendations. Dr. K R. XXXXXXX MD 3722 Central Ave Suite 2 Fort Myers, FL 33901 Dr. XXXXXXX XXXXXXX DO 1528 del Prado Blvd S Cape Coral, FL 33990 Dr. XXXXXXX R. Baldinger, MD 13813 Metro Pkwy Fort Myers, FL 33912 I hope it helps. take good care of yourself and dont forget to close the discussion please. May the odds be ever in your favour. Regards Khan