Treatment Guideline Chart
Scleroderma is a connective tissue disorder characterized by skin thickening and fibrosis. It is rare, autoimmune and chronic.
It has an idiopathic cause and not contagious.
Early microvascular damage, mononuclear cell infiltrates and slowly developing fibrosis are the important features of the tissue lesions.
The leading causes of death are pulmonary fibrosis, pulmonary arterial hypertension and primary cardiac damage.

Scleroderma Patient Education

Patient Education

  • Educate patient on scleroderma and its different types, their symptoms, any change or worsening of symptoms that should prompt patient to seek immediate medical care, available treatments and side effects, and diagnostic tests for detection of possible complications
  • An exercise or rehabilitation program designed by a physiotherapist is most crucial
    • To reduce contractures and functional impairment
    • To minimize joint deformities and strengthen the muscles
    • To keep the blood freely flowing
  • Rest if joints become inflamed
  • Skin care is very important to keep a good supply of blood flowing to the skin
    • Keep the whole body warm to help open the blood vessels of the skin, especially in the hands and feet
    • Avoid strong detergents or other substances that can irritate the skin
    • Prevent drying of skin
    • Use moisturizers and topical emollients to soften and protect the skin
    • Clean digital ulcer wounds with soap and water or physiological serum and use appropriate occlusive dressings
  • Cosmetic makeup may be used to cover up lesions
    • Inactive lesions with atrophic changes may be managed with injectable cosmetic fillers, injection of autologous fat transplantation or surgical excision
  • Have a healthy and balanced diet and adequate hydration, minimize caffeine intake
  • Avoid high doses of vitamin C (>1000 mg) as it promotes collagen formation and emotional stress as it reduces blood flow
  • Quit smoking
  • Avoid sympathomimetic decongestant medications (eg Pseudoephedrine) and high-dose corticosteroid use (>15 mg of Prednisone daily) if possible
  • Avoid exposures to silica or solvents and factors which aggravate Raynaud’s phenomenon, eg hammering, vibration, trauma, exposure to cold, smoking, vasoconstrictor drugs, etc
  • Check blood pressure regularly to monitor for possible complications including scleroderma renal crisis 
  • Educate patient on oral hygiene 
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