There are no products in the cart.There are no products in the cart.Home » Pain Pathology » Guidelines for Diagnosis and Treatment of Musculoskeletal Diseases » Generalized SclerodermaSystemic scleroderma is a systemic disease of unknown etiology characterized by decreased elasticity, sclerosis of the skin, microvascular damage, and damage to internal organs (mainly in the gastrointestinal tract). , blood vessels, heart, lungs, kidneys).Generalized scleroderma is an autoimmune disease that occurs mainly in women, accounting for 80% and usually occurs between the ages of 40 and 50 years.The disease is more common in the black population with a rate of 290/1 million people, and this rate in Europeans and North Americans is 130-140/1 million people.The cause of scleroderma is unknown but it is an autoimmune disease with the presence of autoantibodies such as antinuclear antibodies (DNA), anticentromer antibodies (ACA), and Scl-70 antibodies. The influence of factors such as endocrine, environment, genetics.The disease usually begins silently for a long time with the main symptom being Raynaud's syndrome due to constriction of the arterioles or arteries in the extremities such as fingers and toes that appear when exposed to heat. cold or when there is a strong emotional change with a change in skin color on the extremities in three degrees: pale, pale blue, red purple.Raynaud's syndrome occurs in 90-98% of patients with generalized scleroderma and often precedes skin lesions by months or years.Skin lesions: usually starting from the fingers (swollen fingers and hands), thickening of the skin, progressive hardening of the skin, gradually spreading to the forearms, arms, face, upper part of the neck, chest, abdomen … Hardening of the skin is getting worse and worse, making it difficult for the patient to move.Loss of skin pigmentation (common on the back of the hands, neck, chest, back).There is a phenomenon of calcium deposition in the soft tissues, causing itching and ulceration of the adjacent skin.Loss of skin wrinkles (most pronounced on the face) makes the patient less able to express emotions in facial expressions and difficult to open the mouth.- Ulcerative, necrotic lesions at the extremities due to prolonged Raynaud's syndrome.CREST syndrome: combination of symptoms of calcification (Calcinosis), esophageal spasm (Esophalageal), Raynaud's syndrome (Raynaud), scleroderma (Sclero-dactylic) and dilated arteries (Telangiectasis) ).– About 50-70% of patients have joint symptoms: multi-joint pain, mainly the joints in the upper extremities, may have arthritis but no sequelae of joint deformity.- Esophageal damage occurs in 50-60% of patients with symptoms: burning sensation, fullness behind the sternum, symptoms of gastroesophageal reflux, hardening and spasm of the esophagus making it difficult for patients to swallow (especially is with solid food).The most common lung injury is pulmonary fibrosis: the patient has a dry cough, difficulty breathing on exertion.Auscultation of the lungs with crackles or crackles in the presence of pulmonary superinfection.There may be a pleural effusion with a small amount of fluid.- Patients with tachycardia, or arrhythmia of varying degrees.There may be heart failure, cardiac tamponade when there is a large increase in pulmonary artery pressure.Kidney damage: kidney failure.- Bilan inflammatory positive: increased erythrocyte sedimentation rate, increased C-reactive protein (CRP).Irreversible anemia due to chronic inflammatory process, kidney failure...– Biochemical tests: liver function, kidney function... may change when there is damage to liver, kidney– Immunoassay: antinuclear antibodies are positive in 30-70% of patients with generalized scleroderma.- Cardiopulmonary and computed tomography lung scans may show lesions: pleural effusion, interstitial lung injury or pulmonary fibrosis of other degrees.– Electrocardiogram: detect arrhythmiasEchocardiography: assess cardiac function, pericardial effusion and measure pulmonary artery pressure.- Abdominal ultrasound.- Capillaryoscopy of the extremities: a decrease in the number and constriction of the capillaries of the extremities is seenThe American College of Rheumatology (ACR) criteria for the diagnosis of systemic scleroderma in 1980 (with a sensitivity of 97% and specificity of 98%) are the most widely used in clinical practice. and sub:– Main criterion: diffuse scleroderma.Scleroderma was diagnosed when the primary endpoint was present or two thirds of the minor criteria were present.There is also ABCDCREST standard for scleroderma diagnosis (UF Hanstein - German Dermatology Association) which is also applied in clinical practice.- Diffuse scleroderma: with symptoms of systemic sclerosis, Raynaud's syndrome, damage to internal organs.- Focal scleroderma: CREST syndrome (Calcinosis, Raynaud, Esophageal, Sclerodactyly, Teleangiectasia): including manifestations: subcutaneous calcification of extremities, Raynaud's syndrome, esophageal lesions, sclerosis scalp, and vasodilatation- Combined syndrome of scleroderma and other autoimmune diseases such as systemic lupus erythematosus, dermatomyositis, and rheumatoid arthritis (Overlap syndrome).– Systemic lupus erythematosus- Rheumatoid arthritis.Currently, there is no cure or cure for scleroderma, so the main treatment for scleroderma is symptomatic treatment to control the progression of the disease, treat complications and limit complications of the disease.Non-drug treatment:- Exercise instructions suitable for health status, breathing exercises and full body massage regularly.- Symptoms in the skin (calcification of the skin, scleroderma..): d-penicillamine, colchicine, interferon gama, skin moisturizers, antihistamines– Osteoarthritis symptoms: physical therapy and mobilization therapy, pain relievers, non-steroidal anti-inflammatory drugs.– Vascular syndrome (Raynaud): warm extremities, physical therapy, peripheral vasodilators, channel blocker drugs..Injury to internal organs (gastric syndrome, esophageal syndrome, pulmonary hypertension, pulmonary fibrosis...): corticosteroids, immunosuppressive drugs, proton pump inhibitors, etc.Non-drug treatment: a diet rich in protein and vitamins, no smoking, keeping hands and feet warm.Mobility therapy and physical therapy (thermotherapy in the extremities, mud or mineral water immersion in scleroderma).Use skin moisturizer, light therapy…Drug treatment:Applying treatment to scleroderma patients with severe vascular damage, at risk of extremity necrosis or interstitial lung damage… can use one of the following drugs:Corticosteroids (prednisolone 10-60mg/day) should not be treated with high-dose and long-term corticosteroids.Corticosteroids should be used with caution in patients with scleroderma because of the possible risk of a renal crisis, especially at high doses.Azathioprine: 1.5-3mg/dayCyclophosphamide: 3-6mg/kg/day (Can be given orally or intravenously) Cyclosporin A: 50-100mg/dayMycophenolate mofetil: 250-500mg/day.Plasmapheresis for removal of immune complexes in advanced cases.- Surgical treatment:Indications for surgical treatment of necrotic limb amputation when medical treatment fails.The disease is often chronically progressive and has exacerbations of disease.Scleroderma patients with only skin lesions have a better prognosis than scleroderma patients with visceral lesions.Prognosis and life expectancy of patients are highly dependent on early diagnosis and treatment of diseases and organ damage such as pulmonary fibrosis, pulmonary hypertension, heart failure, and kidney failure.Tsun Vietnam Joint Stock Company[DoctorHome DH14] DoctorHome DH-14 multi-function therapy machine (standard)Lower extremity musculoskeletal support[Wonder MF508N] Wonder MF5-08N Physiotherapy Machine (New)Dong A Pharmaceutical Trading Co., LtdEast Asia medium frequency pulse generator (Model: XYZP)Is on sale[GoldLife GL16] GoldLife GL-16 Multi-function physiotherapy machine(Note: The response to treatment courses, machines, and assistive devices is different depending on each person's location! The medical information on the website is for reference only, you may not apply it arbitrarily. unless directed by a physician!)Editor: Dr. Mai Trung Dung |Specialist Level II Doctor (Ha Hoi Medical University - 2015) |Head of Rehabilitation Department of Military Medical Hospital 354 |Member of Central Committee of Vietnam Association of RehabilitationMake an appointment to see a doctor:Morning Afternoon Late afternoonAddress: 17 Hoang Sam, Nghia Do, Cau Giay, Hanoi - Tel: 069,574,080 Showroom: G11/28 Xuan La, Tay Ho, Hanoi - Tel: 084.589.8686Copyright © 2009 - 2022 CLINC PAIN TREATMENT Address: House No. G11, Alley 28, Xuan La, Tay Ho, Hanoi Professional in charge: BSCKII.Mai Trung Dung Head of Rehabilitation Department, District 354 Hospital - Member of Central Committee of Vietnam Rehabilitation Association Treating Pain Clinic |Spine Disease Treatment - Musculoskeletal |Herniated Disc Treatment Pain Treatment Shop |DoctorHome Therapy Machine |Wonder Therapy Machine |Therapy Machine MPT8-12 |GoldLife GL16 Therapy Machine |Doctor100 Roller Note that the information on the Website is for reference only, you may not apply it without a doctor's instruction.Account name or email address *Password *Remember password Sign inForgot password?A link to set a new password will be sent to your email address.Your personal information will be used to enhance your experience of using the website, manage access to your account, and for other specific purposes described in the privacy policy.