What are the treatments for scleroderma

Scleroderma is a common connective tissue disease in clinical practice. Patients may develop skin hardening, which is called localized scleroderma. There are many treatments for scleroderma. In addition to drug therapy, there are also some physical therapies. At the same time, the principle of early treatment should also be followed.

1. Treatment principles

Early diagnosis and early treatment are helpful in preventing disease progression. The principle is vasodilation, anti-fibrosis, immunosuppression and immunoregulation, but there is no specific drug.

2. Drugs that improve the condition

(1) Drugs targeting blood vessels and improving microcirculation include aspirin and dipyridamole, which change platelet function. Ketanzerin is a histamine antagonist that can reduce the frequency and severity of Raynaud's phenomenon and improve the prognosis of digital ulcers. However, the drug is ineffective in improving skin thickening or internal organ damage. The calcium channel blocker nitrendipine is a potent vasodilator. Angiotensin-converting enzyme inhibitors such as meprobamate and enalapril can effectively control hypertension and early renal insufficiency. Other drugs that improve microcirculation include Danshen and low-molecular-weight dextran injection, which have certain effects on skin sclerosis, joint stiffness and pain.

(2) After one month of use, the dosage of glucocorticoids and immunosuppressant prednisone should be reduced to maintain the dosage. Methotrexate and cyclosporine A (CsA) have shown certain therapeutic effects in trials with a small number of people. Penicillamine is an immunomodulator that has a certain effect on inhibiting skin sclerosis and visceral damage. For patients with interstitial lung disease, glucocorticoids and CTX can change the condition, while tripterygium wilfordii glycosides and macrolides such as roxithromycin can alleviate symptoms. Intravenous prostaglandins increase survival in patients with primary pulmonary hypertension.

3. Note

Renal crisis is the most feared visceral complication of scleroderma, and the most common consequence is renal failure. ACEI or ARB antihypertensive drugs can reverse severe hypertension, renal anemia and control hypertension. Improvements in hemodialysis and renal dialysis therapy have also brought hope for renal crisis, and kidney transplantation has improved survival rates.