Scleroderma, or systemic sclerosis, is a rare autoimmune disease that affects the skin and some internal organs. It is characterized by hardening and tightening of the skin and connective tissues. Depending on the severity of the condition, a number of specialists may be involved in the care and treatment of a patient with scleroderma.
A person with scleroderma will typically start with their primary care physician. From there, they may be referred to specialists depending on the severity of their scleroderma, including a rheumatologist, dermatologist, or pulmonologist.
Rheumatologists specialize in autoimmune diseases, while dermatologists specialize in skin diseases. Pulmonologists specialize in pulmonary complications of scleroderma.
In some cases, a patient with severe scleroderma may be referred to a team of specialists that might include members of other specialties, such as infectious disease specialists, cardiologists, gastroenterologists, hand surgeons, and physical and speech therapists.
It is important to have the right team in place to monitor the condition and provide treatment. Treatment may include medications, lifestyle modifications, physical therapy, occupational therapy, and surgery to manage joint pain or muscle weakness.
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How do you confirm scleroderma?
Confirming a scleroderma diagnosis can be done through a combination of physical exams, laboratory tests, imaging studies, biopsies, and even a pulmonary function test. Physical exams often focus on the skin, joints, and internal organs to check for signs and symptoms, such as thickened, shiny skin; hard patches on the skin; calcium deposits, joint pain, difficulty swallowing, and internal organ problems such as those affecting the heart, lungs, and kidneys.
Laboratory tests, such as complete blood count, urinalysis, and erythrocyte sedimentation rate, can be conducted to check for other health issues or to help rule out other potential conditions. Imaging studies such as X-rays, CT scans, and MRIs can help to detect changes in affected areas and organs, while biopsies take samples of skin tissue which can then be examined under a microscope.
Finally, a pulmonary function test may be used to assess the health of the lungs. Ultimately, a combination of all of these tests is necessary to confirm a scleroderma diagnosis.
Can a rheumatologist diagnose scleroderma?
Yes, a rheumatologist can diagnose scleroderma. Generally, a rheumatologist would take a complete medical history, perform a physical examination, and order diagnostic tests such as blood tests, urine tests, imaging studies, and biopsy.
These tests help the rheumatologist assess skin changes and thickening, examine organs such as the heart, lungs, and kidneys, and look for inflammation and autoantibodies. The examination may include assessing the mouth, face, hands, and other parts of the body for skin problems.
Once the diagnosis is made, the rheumatologist will develop an individualized treatment plan. The treatment plan may consist of medications, lifestyle changes, physical therapy, and other therapies. It is important for the patient to stay in close contact with the rheumatologist to ensure that the treatment plan is working and to monitor any changes or side effects.
What labs are elevated in scleroderma?
Scleroderma is a chronic autoimmune disorder that leads to thickening and hardening of the skin. It can also affect the connective tissue and certain internal organs like the heart and lungs. Elevated lab results may include various indicators of an autoimmune process, such as an elevated antinuclear antibody (ANA) titer, anti-centromere antibody (ACA) and anti-SCL-70 (anti-topoisomerase I antibody).
These are all autoantibodies that can help diagnose an autoimmune disorder. Elevated levels of C-reactive protein (CRP), sedimentation rate, and certain cytokines such as interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) may indicate inflammation and other signs of the disorder.
Additionally, scleroderma can cause changes in electrolytes, so serum electrolytes such as calcium, phosphate, potassium and bicarbonate may be tested. Testing kidney function and liver enzymes may also be useful in diagnosing scleroderma, as well as some of the complications associated with it.
Where does scleroderma usually start?
Scleroderma usually starts in the skin and affects the extremities, such as the hands, feet, and face. It can also affect other body parts, including the digestive system, lungs, heart, and kidneys. In a localized form of scleroderma (also referred to as morphea), the disease typically appears as plaques on the skin that may enlarge and change color.
Over time, the patches can turn hard, shiny and scar-like, leading to tightened skin known as morphealike sclerosis. In systemic scleroderma, patches of thickened skin may start in one area and spread throughout the body.
Systemic scleroderma generally affects the internal organs and is often accompanied by fatigue, joint pain, and problems with the heart, lungs, and kidneys. In either form, however, affected individuals may also experience stiffness, joint pain, and muscle weakness.
The cause of scleroderma is not known.
Is scleroderma a neurological disorder?
No, scleroderma is not a neurological disorder. Scleroderma is a chronic connective tissue disorder that results in hardening and tightening of the skin, as well as connective tissues and organs. It is caused by the body’s immune system mistakenly attacking healthy cells and tissues.
Common symptoms include tightening of the skin on the face, chest, and hands; heat sensitivity; irritation or redness of the skin; and narrowing of fingertips. Scleroderma can also affect other organs, including the lungs, heart, and kidneys.
Neurological problems have been reported in people with scleroderma, such as difficulty sleeping, reduced sensation, and muscle weakness, but these are not symptoms specifically associated with the disorder and are generally related to other systemic complications.
Treatment is typically aimed at reducing inflammation, managing symptoms, and preventing further organ damage.
Does scleroderma show up in blood work?
Scleroderma does not typically show up in blood work, as it is a connective tissue disorder, not a blood disorder. However, scleroderma can cause an elevated erythrocyte sedimentation rate and antinuclear antibodies (ANA) which can be detected through blood work.
Additionally, if scleroderma has caused anemia, kidney failure, or another blood disorder, these may show up in blood work. Various medications that may be used to treat scleroderma may also show up in blood work.
It is important to speak with a qualified healthcare provider to determine appropriate tests and diagnose scleroderma.
What is the marker for scleroderma?
Scleroderma, also known as systemic sclerosis, is a chronic autoimmune disease that can cause a wide range of symptoms, including hardening and tightness of the skin, joint pain and stiffness, and difficulty breathing.
As the disease may present differently in different patients. However, some of the more common markers that can indicate scleroderma include skin thickening, an enlarged esophagus, anemia, Raynaud’s phenomenon, and ANA antibodies, which can be tested for with blood assays.
Other tests, such as high-resolution ultrasound, magnetic resonance imaging, and targeted biopsies may also be used to identify signs of scleroderma in the skin, organs, or muscles. As scleroderma can sometimes be difficult to diagnose, doctors may order additional tests or request a referral to a specialist who can provide more extensive insight into the condition.
What were your first symptoms of scleroderma?
My first symptoms of scleroderma were a deep, burning pain in my hands, fingers and feet. I also experienced some mild tenseness in my skin and joints, as well as a tingling sensation in my face. I began to notice small red spots on my arms and face, along with patches of dry and tight skin on my hands, elbows, and feet.
I also began to experience a feeling of weakness and fatigue in my daily activities. I experienced joint stiffness upon waking in the morning, which slowly progressed until it felt as if I had no energy to move.
I also noted that tasks which once were easy were now becoming much more difficult and seemed to take much longer.
Additionally, I had difficulty sleeping, as my body felt uncomfortable and my breath felt shallow. I had trouble keeping myself warm compared to before, and my fingertips and toes began to feel numb.
I then noticed a slight decrease in my strength and my ability to do certain tasks due to the pain and discomfort I was feeling.
Can scleroderma be seen on CT scan?
Yes, scleroderma can be seen on CT scans. Generally, it appears on a CT scan as thickening of the skin and sometimes indentations, as well as thickening of the blood vessels and muscles in the affected area.
In severe cases, it can be accompanied by calcium deposits as well as enlargement of the lymph nodes. In some cases, it can be seen as calcifications, which are large accumulations of calcium salts that can be seen radiographically.
Combined with clinical assessments, a CT scan can help to diagnose scleroderma and can provide a more detailed picture of the disease, including the effects it has on other organs and tissues.
How do you slow the progression of scleroderma?
The progression of scleroderma can be slowed with a combination of treatments which might include prescription medications, lifestyle changes, supportive therapies and integrative medicine treatments.
Prescription medications can be used to provide symptom relief and prevent tissue damage. These might include corticosteroids, disease-modifying antirheumatic drugs (DMARDs) such as methotrexate or hydroxychloroquine, immunosuppressants such as mycophenolate mofetil and tacrolimus, or biologics such as tocilizumab.
Lifestyle changes can help to both reduce symptoms and slow the progression of scleroderma. Eating a balanced diet high in fruits, vegetables and whole grains and low in processed foods can help to reduce inflammation.
Limiting caffeine, alcohol, and salt intake may also be beneficial. Quitting smoking if you smoke is important, as it can damage your lungs and cause inflammation. Regular exercise can help to reduce pain and stiffness, improve mobility, and can help improve overall well-being.
Supportive therapies such as physical therapy can help to maintain flexibility, range of motion and strength, as well as to reduce joint and muscle pain. Occupational therapy can focus on improving overall independence.
A speech therapist might be appropriate to help improve swallowing.
Complementary and integrative medicine treatments such as yoga, acupuncture, tai chi, and massage therapy can also be beneficial. Supplements such as omega-3 fatty acids and oral proteolytic enzymes are often recommended for scleroderma patients.
Living with a chronic condition such as scleroderma can be very difficult, so seeking counseling and engaging in stress-relieving activities such as meditation or deep breathing can help to reduce stress and improve overall well-being.
What is the most serious complication of scleroderma?
The most serious complication of scleroderma is organ damage, which can occur due to restriction of blood flow caused by narrowing of the arteries or veins. This can affect multiple organs and can cause a number of potential issues.
Narrowing of the arteries can lead to issues such as stroke, heart attack, pulmonary hypertension, and coronary artery disease. Narrowing of the veins can lead to deep vein thrombosis and pulmonary embolism.
Other long-term organ damage that can result from scleroderma may include kidney failure, pulmonary fibrosis, liver fibrosis, and acid reflux. Certain medications used to treat scleroderma can also cause side effects such as liver or kidney damage.
What causes scleroderma to flare up?
Scleroderma is an autoimmune disease characterized by the overproduction of certain connective tissues in the body, causing hardening and tightening of the skin and tissues. Although the cause of scleroderma is still largely unknown, scientists have identified certain factors that may contribute to the onset and/or flare-up of the disease.
These can include:
• Stress or emotional upset: Stress can cause a person’s immune system to become more active, and this can trigger a flare-up of scleroderma.
• Cold weather: Cold temperatures can cause the skin to tighten, which can exacerbate symptoms of scleroderma.
• Infection: People with scleroderma are more susceptible to bacterial and viral infections, which can trigger a flare-up of the disease.
• Certain medications: Some medications can worsen the symptoms of scleroderma by causing the body to produce more collagen, the substance responsible for the thickening and hardening of the skin and other tissues affected by the disease.
• Exposure to certain chemicals: Certain chemicals, such as solvents, may increase the production of connective tissue in the body and cause a flare-up.
• Hormonal changes: Changes in hormone levels in the body can cause a flare-up.
Although it can be difficult to pinpoint the exact cause of a scleroderma flare-up, it is important to seek medical attention if you experience any new or worsening symptoms of the disease. Some treatments, such as topical medications and physical therapy, may help reduce the severity of symptoms and prevent flare-ups.
What autoimmune disease does a rheumatologist treat?
A rheumatologist is a medical doctor specializing in the diagnosis and treatment of rheumatic diseases, which include autoimmune diseases. These medical professionals have extensive expertise in the diagnosis and treatment of diseases related to the musculoskeletal system, including: arthritis, inflammatory myopathies, systemic lupus erythematosus (SLE), vasculitis, Raynaud’s phenomenon, scleroderma, infectious and collagen diseases, and osteoporosis.
Other conditions and disorders treated by rheumatologists include gout, ankylosing spondylitis, fibromyalgia, tendonitis, fibromyositis, chronic joint and muscle pain, psoriatic arthritis and other spondyloarthropathies.
Additionally, they are often consulted in cases of suspected immune-mediated diseases such as lupus and other connective tissue disorders. Rheumatologists typically coordinate a team of doctors, specialists, and therapists to ensure an optimal diagnosis and treatment plan is established.
