Scleroderma

Scleroderma is a chronic (ongoing) condition where your immune system attacks the connective tissues in your body. Connective tissue is the tissue that supports your:

• joints
• muscles
• skin
• blood vessels
• organs

There are 2 types of scleroderma:

1. localised scleroderma
2. systemic sclerosis

Localised scleroderma (morphoea)

Localised scleroderma usually only affects your skin. It's also called morphoea.

About 7 in every 10 people with scleroderma have localised scleroderma.

Symptoms of localised scleroderma include:

• thickening and hardening of your skin — this often occurs on your fingers and arms
• discoloured patches of skin — this usually occurs on your chest, face, limbs and back

Systemic sclerosis (scleroderma)

Systemic sclerosis (scleroderma) can affect your skin, as well as other organs, such as your:

• blood vessels
• heart
• lungs
• kidneys
• digestive system

Systemic sclerosis is often classified as limited or diffuse:

• Limited systemic sclerosis affects small areas of skin, such as your hands and feet, and slowly affects your organs.
• Diffuse systemic sclerosis affects larger areas of skin and affects your other organs faster.

The symptoms of scleroderma depend on:

• the type of scleroderma you have
• which part of your body is affected

Some common symptoms of scleroderma include:

• tiredness
• joint pain and swelling
• muscle pain
• reflux or heartburn
• skin thickening and tightness
• swelling and stiffness of your hands
• Raynaud's phenomenon — this is a condition which causes your fingers or toes to change colour and feel cold, numb or painful

Symptoms of scleroderma can range from mild to severe.

Scleroderma is an autoimmune disease, where your immune system mistakenly attacks healthy tissue. This causes your body to make too much collagen. As a result, your skin and connective tissues become hard and tight.

It's not clear what causes your immune system to attack connective tissue. It may be a combination of genetics and environmental factors.

Females are more often affected by scleroderma than males. Most people are diagnosed between 25 and 55 years of age.

See your doctor if you have any symptoms of scleroderma.

To diagnose scleroderma, your doctor will:

• ask about your symptoms
• take your medical history, including asking if you have a family history of scleroderma
• examine you
  

While there is no specific test for scleroderma, your doctor may recommend tests such as a:

• blood test — this can help diagnose an autoimmune or connective tissue disorder
• skin biopsy (small skin sample is removed and tested) — this can help confirm if scleroderma is affecting your skin
• lung function test — this is to check if your lungs are affected
• chest x-ray — this is to check if your heart is affected

To help confirm the diagnosis, your doctor may refer you to a:

• dermatologist (skin specialist)
• rheumatologist (a doctor who is an expert in connective tissue disorders and arthritis)

Unfortunately, there is no cure for scleroderma. However, there are treatments available.

Treatment for scleroderma aims to:

• manage your symptoms
• minimise damage to your body
• maintain your ability to function

Treatment for scleroderma may involve different healthcare professionals. You may need to see a:

• rheumatologist
• dermatologist
• physiotherapist
• occupational therapist

Self-care at home

You can help manage scleroderma with self-care measures:

• Avoid getting cold and wear gloves and socks to keep your hands and feet warm. This helps to prevent Raynaud's phenomenon.
• Keep your skin moisturised and clean to prevent dryness and infection.
• Do regular range of motion exercises, especially for your hands and face. This helps to keep your skin and joints flexible.

Lifestyle changes can also help:

• Quit smoking or vaping and avoid exposure to smoke.
• Avoid air pollution as much as possible.
• Do aerobic exercise to help improve your lung function.
• Rest when you need to.
• Try to avoid stress and do relaxation exercises.

Medicines for scleroderma

Some medicines can help manage the symptoms of scleroderma, including:

• calcium-channel blockers to relax and widen your blood vessels
• aspirin to improve your blood flow
• medicines to help treat reflux
• medicines that suppress your immune system

Ask your doctor or pharmacist which medicine is right for you.

It's important to visit your doctor regularly to make sure your medicines are working for you.

Other treatment options

A physiotherapist or occupational therapist can show you exercises to help with:

• limited joint movement
• muscle weakness
• tight or hard areas of skin

Talk to your doctor or an occupational therapist about equipment that can make it easier to manage day-to-day.

Possible complications of scleroderma include:

• pulmonary fibrosis (a type of lung disease)
• hypothyroidism (low thyroid hormone levels)
• osteomyelitis (bone infection)
• diarrhoea
• skin infection
• pulmonary hypertension (high blood pressure in the blood vessels in your lungs)
• high blood pressure

It's currently not possible to prevent scleroderma.

You can help prevent complications from Raynaud's phenomenon by:

• stopping smoking
• avoiding getting cold
• reducing stress

Scleroderma Australia has information brochures and local support groups for people with scleroderma.

Musculoskeletal Health Australia has resources and support for people with scleroderma.

The Sydney Children's Hospital Network offers information on localised scleroderma.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.