close
Skip to main content
Log in

The Current Treatment of Scleroderma

  • Practical Therapeutic
  • Published:
BERJAYA Drugs Aims and scope Submit manuscript

Summary

The treatment of scleroderma is determined by the stage of the disease, associated organ involvement or the presence of features overlapping those of other connective tissue disease.

Raynaud’s phenomenon is responsive to vasoactive medication, but recently heat and plasma exchange have been shown to be more effective, reducing the need for systemic medication.

In stages II and III of the disease, administration of non-toxic penicillamine in low doses for 2 to 4 years is the preferred treatment. Plasma exchange may offer some hope in the early stages. The treatment of the renal crisis of scleroderma with angiotensin-converting enzyme inhibitors has reduced mortality from this complication. These drugs are currently the preferred treatment for the hypertension of renal scleroderma.

The symptomatic treatment of the pulmonary, gastrointestinal, and soft tissue complications of scleroderma is also discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+
from $39.99 /Month
  • Starting from 10 chapters or articles per month
  • Access and download chapters and articles from more than 300k books and 2,500 journals
  • Cancel anytime
View plans

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Alarcon-Segovia D, Ramos-Niembro F, de Kasep GI, Alcocer J, Tamayo PP. Long-term evaluation of colchicine in the treatment of scleroderma. Journal of Rheumatology 6: 705–712, 1979

    PubMed  CAS  Google Scholar 

  • Asboe-Hansen G. Treatment of generalized scleroderma with inhibitors of connective tissue formation. Acta Dermato-Venereologica (Stockholm) 55: 461–465, 1975

    CAS  Google Scholar 

  • Asboe-Hansen G. Scleroderma. Journal of the American Academy of Dermatology 17: 102–108, 1987

    Article  PubMed  CAS  Google Scholar 

  • Czirják L, Dankö K, Schlammadinger J, Surányi P, Tarnási L, et al. Progressive systemic sclerosis occurring in patients exposed to chemicals. International Journal of Dermatology 26: 374–378, 1986

    Article  Google Scholar 

  • Fuchs D, Fruchter L, Fishel B, Holtzman M, Yaron M. Colchicine suppression of local inflammation due to calcinosis in dermatomyositis and progressive systemic sclerosis. Clinical Rheumatology 5: 527–530, 1986

    PubMed  CAS  Google Scholar 

  • Horowitz M, Maddern GH, Maddox A, Wishart J, Chatterton BE, et al. Effects of cisapride on gastric and esophageal emptying in progressive systemic sclerosis. Gastroenterology 93: 311–315, 1987

    PubMed  CAS  Google Scholar 

  • Housset E. Intér et de certains dérivés de la colchicine dans le traitement des syndromes sclérodermiques. Annales de Dermatologie et de Syphiligraphie 94: 31–34, 1967

    PubMed  CAS  Google Scholar 

  • Jablonska S (Ed.). Scleroderma and pseudoscleroderma, 2nd ed., Polish Medical Publishers, Warsaw, 1975

    Google Scholar 

  • Krieg T, Meurer M. Systemic scleroderma: clinical and pathophysiologic aspects. Journal of the American Academy of Dermatology 18: 457–481, 1988

    Article  PubMed  CAS  Google Scholar 

  • Mascaro G, Cardario G, Bordin G, Tarditi M, Ferraris G, et al. Plasma exchange in the treatment of nonadvanced stages of progressive systemic sclerosis. Journal of Clinical Apheresis 3: 219–225, 1987

    Article  PubMed  CAS  Google Scholar 

  • McCune MA, Winkelmann RK, Osmundson PJ, Pineda AA. Plasma exchange: a controlled study of the effect in patients with Raynaud’s phenomenon and scleroderma. Journal of Clinical Apheresis 2: 206–214, 1983

    Article  Google Scholar 

  • Medsger Jr TA. Progressive systemic sclerosis. Clinics in Rheumatic Diseases 9: 655–670, 1983

    PubMed  Google Scholar 

  • Medsger TA. D-penicillamine treatment of lung involvement in patients with systemic sclerosis (scleroderma). Arthritis and Rheumatism 30: 832–834, 1987

    Article  PubMed  Google Scholar 

  • Nimni ME. Penicillamine and collagen metabolism. Scandinavian Journal of Rheumatology 28 (Suppl.): 71–78, 1979

    Article  PubMed  CAS  Google Scholar 

  • Priollet P, Boudot N, Fiessinger J-N, Vayssairat M, Housset E. Traitement de la sclérodermie systémique. Anales de Dermatologie et de Vénéréologie 111: 595–607, 1984

    CAS  Google Scholar 

  • Rodnan GP (Ed.). Progressive systemic sclerosis. Clinics in Rheumatic Diseases 5: 1–306, 1975

    Google Scholar 

  • Rustin MHA, Almond NE, Beacham JA, Brooks RJ, Jones DP, et al. The effect of captopril on cutaneous blood flow in patients with primary Raynaud’s phenomenon. British Journal of Dermatology 117: 751–758, 1987

    Article  PubMed  CAS  Google Scholar 

  • Seibold JR, Jageneau AHM. Treatment of Raynaud’s phenomenon with ketanserin, a selective antagonist of the serotonin: (5-HT2) receptor. Arthritis and Rheumatism 27: 139–146, 1984

    Article  PubMed  CAS  Google Scholar 

  • Shapiro LS, Prince RK, Buckingham RB, Rodnan GP. D-penicillamine treatment of progressive systemic sclerosis (scleroderma): a comparison of clinical and in vitroeffects. Journal of Rheumatology 10: 316–318, 1983

    PubMed  CAS  Google Scholar 

  • Steen VD, Medsger Jr TA, Rodnan GP. D-penicillamine therapy in progressive systemic sclerosis (scleroderma): a retrospective analysis. Annals of Internal Medicine 97: 652–659, 1982

    PubMed  CAS  Google Scholar 

  • Surwit RS, Gilgor RS, Allen LM, Duvic M. A double-blind study of prazosin in the treatment of Raynaud’s phenomenon in scleroderma. Archives of Dermatology 120: 329–331, 1984

    Article  PubMed  CAS  Google Scholar 

  • Traub YM, Shapiro AP, Rodnan GP, Medsger TA, McDonald Jr RH, et al. Hypertension and renal failure (scleroderma renal crisis) in progressive systemic sclerosis: review of a 25-year experience with 68 cases. Medicine (Baltimore) 62: 335–352, 1983

    CAS  Google Scholar 

  • Winston EL, Pariser KM, Miller KB, Salem DN, Creager MA. Nifedipine as therapeutic modality for Raynaud’s phenomenon. Arthritis and Rheumatism 26: 1177–1180, 1983

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fergus Oliver, G., Winkelmann, R.K. The Current Treatment of Scleroderma. Drugs 37, 87–96 (1989). https://doi.org/10.2165/00003495-198937010-00006

Download citation

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.2165/00003495-198937010-00006