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How Do I Know I Have Scleroderma?

Scleroderma is often difficult to diagnose. It may look like many other diseases. Changes in skin thickness, the presence of specific antibodies in the blood, or early blood-vessel changes can be helpful in diagnosing the disease. Your doctor may remove a small tissue sample (biopsy) for analysis to help in the diagnosis of scleroderma. However, there is no single test that can tell for sure whether you have the disease.

One of the most useful indicators doctors use is the nail-fold capillary test. This focuses on one of the earliest identifiable signs of scleroderma: the disappearance of tiny microvessels in the skin of the hands and feet. The test involves examining skin at the base of the fingernail. While it alone does not indicate scleroderma, when combined with several of the characteristic symptoms, it can aid the diagnosis. For a definitive diagnosis, a qualified physician or team of physicians must carefully analyze many test results, perform a physical exam, and take a complete medical history.

What Are the Treatments?

There is no cure for scleroderma. Treatment focuses on relieving symptoms and reducing the risk of complications.

Localized skin changes may be treated with topical agents like moisturizers or corticosteroid medications. If the disease is more extensive sometimes minocycline, an antibiotic, is used to control the skin symptoms. Light therapy (phototherapy) has also shown some benefit but more research is needed.

Vasodilators, medicines that relax and open the blood vessels, may be prescribed to relieve Raynaud's phenomenon. Avoiding exposure to cold and sunlight is also helpful. Drugs called angiotensin converting enzyme (ACE) inhibitors and other blood pressure medications can help control blood pressure and may be used to alleviate serious kidney complications. Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen and ibuprofen, may ease joint pain. Indigestion can be treated with drugs that decrease stomach acidity. Your doctor may suggest antibiotics, special diets and medications to improve your gut's ability to digest food
D-penicillamine is thought to decrease the production of collagen and may delay the progress of the disease. Steroids, such as cortisone or prednisone, may be used to decrease inflammation.

Medications that suppress the immune system, like cyclophosphamide and methotrexate, may be helpful in some.

Stretching and physical therapy may help keep joints and tissue strong and flexible. Raynaud's phenomenon can be relieved somewhat by staying warm. Wearing gloves and warm socks will help.

Rarely, orthopedic hand or cosmetic surgery may be necessary to correct severe joint contractures, skin deformities, or scars. Usually before surgery can be performed, the disease must be in remission for at least five years.