Treatment of scleroderma

Scleroderma is a common disease. It is a systemic connective tissue disease. The occurrence of this disease is closely related to genetic factors and abnormal immune function. Especially in women, the incidence of this disease is relatively high. If it is not treated in time, it will also affect the lungs, kidneys, heart and other organs. Everyone should want to know more about the treatment of scleroderma.

I don't know how much you know about scleroderma. You probably rarely see such patients. The common sites of scleroderma are the waist and back. There are also different types of scleroderma. If such a disease occurs, you should be able to learn about the treatment of scleroderma in a timely manner.

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In some cases, the disease can stop progressing or even improve after treatment. There is no significant difference in treatment between the two types.

1. General treatment

Remove infected lesions, strengthen nutrition, keep warm and avoid intense mental stimulation.

2. Vasoactive agents

It is mainly used to dilate blood vessels, reduce blood viscosity and improve microcirculation.

(1) Danshen injection is added with low molecular weight dextran and intravenously dripped. It has certain effects on skin sclerosis, difficulty opening the mouth and swallowing, pigmentation, joint stiffness and pain, and Raynaud's phenomenon. However, it is not suitable for patients with bleeding tendency or poor renal function.

(2) Guanethidine is effective for Raynaud's phenomenon (effectiveness is about 50%).

(3) Methyldopa can inhibit Raynaud's phenomenon.

3. Connective tissue formation inhibitor

(1) Penicillamine can interfere with the chain complexes between collagen molecules and inhibit the biosynthesis of new collagen. It has a significant effect on skin thickening and nutritional changes, improves microcirculation and lung function, and can reduce the incidence of organ involvement and improve survival rate. During medication, this drug may irritate the kidneys and suppress the bone marrow, causing leukopenia and thrombocytopenia. If L-pentylindole is taken at the same time, its therapeutic effect is better than taking penicillamine alone.

(2) Colchicine can prevent the conversion of procollagen into collagen and inhibit the accumulation of collagen. It has certain therapeutic effects on skin sclerosis, Raynaud's phenomenon and esophageal changes. If diarrhea occurs during medication, the dosage can be reduced or galactosidase can be given.

(3) Centella asiatica is an active ingredient extracted from the traditional Chinese medicine Centella asiatica. Experimental results have shown that it can inhibit the activity of fibroblasts and soften connective tissue. It is very effective (effectiveness is about 80%) in treating foreign aging sclerosis, eliminating tissue edema, relieving joint pain, and healing ulcers.

4. Anti-inflammatory glucocorticoids

It is effective for the early symptoms of systemic sclerosis, such as inflammation, edema, and joints. Avoid use if proteinuria, hypertension or azotemia is present.

5. Immunosuppressants

Drugs such as azathioprine, chlorambucil, cyclophosphamide, etc. can be used and have certain therapeutic effects on joint, skin and kidney lesions. Combined use with glucocorticoids can often improve efficacy and reduce the dosage of corticosteroids.

Clinical manifestations

1. Localized scleroderma

Some (about 1/3 of patients) localized scleroderma can transform into systemic scleroderma, so regular follow-up examinations are required.

(1) Morphea often occurs on the waist and back, followed by the limbs and face and neck. It manifests as round, oval or irregular edematous patches that are initially light red or purple. After several weeks or months, they gradually expand and harden, and the color changes to light yellow or ivory. There is no sweating or hair loss in the area. After several years, it turns into white or light brown atrophic scars.

(2) Scleroderma zonae is common in children and young people, with more cases in women than in men. The lesions are distributed in a band-like pattern along the intercostals and one side of the limbs, and may be single or multiple. The lesion evolution process is the same as that of morphea.

(3) Guttate morphea often occurs on the neck, chest, shoulders and back. The lesions are the size of a green bean to a nickel and are arranged in clusters in linear patterns. Their evolution process is similar to that of morphea.

2. Acroscleroderma and diffuse scleroderma

Acrofacial sclerosis has Raynaud's phenomenon, skin lesions develop from distal to proximal, with less involvement of the trunk and internal organs, slow disease progression and good prognosis; diffuse sclerosis lesions extend from the trunk to distal, with less Raynaud's phenomenon and more involvement of internal organs. The condition is severe, the disease progresses rapidly, and the prognosis is poor.

(1) Raynaud's phenomenon is the first symptom of most patients, manifested as a three-phase change of whitening, cyanosis, and redness of the fingertips when exposed to cold or emotional fluctuations, which can be relieved by keeping warm;

(2) The skin lesion process can be divided into three stages: edema, sclerosis and atrophy.

Systemic sclerosis is an autoimmune disease that affects multiple systems. In addition to characteristic skin changes, it can also affect internal organs, the most commonly affected being the digestive tract. Almost the entire digestive tract can be affected, such as the esophagus, stomach, and intestines. The second most common organ is the lungs, where interstitial fibrosis may occur to varying degrees. In addition, the heart, kidneys, liver, thyroid, and nervous system can also be affected.

Everyone should have some understanding of the treatment of scleroderma. After the onset of scleroderma, it can cause dysfunction of the body's internal organs. It may occur in different age groups, and the incidence rate in women is 3-4 times that of men. There are many principles for treating this disease. The most important one is to keep warm and anti-inflammation.