Scleroderma Treatment in Guntur

What is scleroderma?

Scleroderma is an autoimmune connective tissue disease in which the immune system drives excess collagen deposition and injury to small blood vessels. Localised scleroderma affects the skin alone. Systemic sclerosis affects skin as well as internal organs — most importantly the lungs, gastrointestinal tract, heart and kidneys.

Almost all patients have Raynaud's phenomenon, often years before other features. Because lung involvement (interstitial lung disease and pulmonary hypertension) and renal crisis are the principal determinants of outcome and are treatable when caught early, structured organ screening from the time of diagnosis is a central part of care.

Symptoms to watch for

• Fingers turning white, then blue, then red in cold or stress (Raynaud's)
• Tight, thickened, shiny skin over the fingers, hands or face
• Puffy fingers, particularly in the morning, early in the disease
• Painful ulcers or pits at the fingertips
• Heartburn, difficulty swallowing, bloating or altered bowel habit
• Breathlessness on exertion or a persistent dry cough
• Joint pain, tendon friction rubs and muscle weakness
• Small dilated blood vessels (telangiectasia) on the face and hands

How it is diagnosed

Investigation is chosen to answer a specific question rather than as a blanket screen. For scleroderma that usually means:

• Clinical assessment including skin scoring and examination for organ features
• ANA with scleroderma-specific antibodies (anti-centromere, anti-Scl-70, anti-RNA polymerase III)
• Nailfold capillaroscopy to detect the characteristic microvascular changes
• High-resolution CT of the chest and pulmonary function tests for lung disease
• Echocardiography to screen for pulmonary hypertension
• Regular blood pressure and renal function monitoring for scleroderma renal crisis
• Oesophageal and gastrointestinal assessment where symptoms warrant

Treatment options at Siva Sakthi

Which of these applies to you depends on what the assessment shows. The options are discussed with you, including what each involves and what recovery looks like.

• Vascular therapyCalcium channel blockers and, in severe digital ischaemia, phosphodiesterase inhibitors or prostacyclin analogues to treat Raynaud's and heal digital ulcers.
• ImmunosuppressionMycophenolate, methotrexate or cyclophosphamide are used for progressive skin and interstitial lung disease, chosen by organ pattern.
• Antifibrotic therapyConsidered in progressive interstitial lung disease alongside immunosuppression.
• Gastrointestinal managementProton pump inhibitors for reflux, prokinetics for dysmotility, and treatment of bacterial overgrowth.
• Renal crisis prevention and treatmentACE inhibitors are the specific treatment for scleroderma renal crisis; blood pressure is monitored to detect it promptly.
• Pulmonary hypertension careTargeted therapy in confirmed cases, with cardiology and pulmonology input.
• Hand therapy and skin careStretching, moisturising, cold protection and meticulous ulcer care to preserve hand function.

Common questions