Medical history (history of illness) represents an important component in the diagnosis of scleroderma. Family history Is there a history of frequent skin diseases, autoimmune diseases in your family? Social history What is your profession? Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and … Scleroderma: Medical History
Chronic cutaneous circumscritical scleroderma Skin and subcutaneous (L00-L99). Lichen sclerosus et atrophicus – rare, chronic inflammatory progressive connective tissue disease that is probably one of the autoimmune diseases. Pseudoscleroderma (tight skin atrophy (atrophy = decrease) under the image of scleroderma). Musculoskeletal system and connective tissue (M00-M99). Incipient systemic scleroderma (diffuse cutaneous type). Systemic scleroderma Skin … Scleroderma: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by chronic cutaneous circumscritic scleroderma: Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Joint contractures (stiffening of joints). The following are the major diseases or complications that may be co-morbid with systemic scleroderma: Respiratory system (J00-J99) Alveolitis (inflammation of the air sacs). … Scleroderma: Complications
There are two main forms as well as several subtypes of scleroderma: Chronic cutaneous circumscritical scleroderma (ICD-10 L94.-: Other localized diseases of connective tissue): confined to the skin and adjacent tissues such as subcutaneous fat, muscle, and bone; most common form of scleroderma A distinction is made between the following subtypes: Plaque type (morphaea) – … Scleroderma: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height [determination of BMI]; further: Inspection (viewing). Skin Skin foci with “lilac-ring” (bluish-red border)? Vascular regions (Raynaud’s syndrome, especially on the hands), telangiectasias (vascular veins)? Mucous membranes [whitish horny foci of oral mucosa … Scleroderma: Examination
Chronic cutaneous circumscritic scleroderma. 1st order laboratory parameters – obligatory laboratory tests. Autoantibodies: antinuclear antibodies (ANA), direct immunofluorescence (DIF). Systemic scleroderma Laboratory parameters 1st order – obligatory laboratory tests. Autoantibodies: ANA (antinuclear antibodies); subsets of scleroderma: Anti-Scl-70 antibody (anti-Scl70-AK (= anti-topoisomerase-I-AK); typical for the diffuse cutaneous form (dSSc)); specific, but positive in only about 15-30%. … Scleroderma: Test and Diagnosis
The disease cannot be treated causally (related to the cause). General therapeutic goals Relief of symptoms Ensuring the quality of life Avoidance or therapy of secondary diseases / complications Therapy recommendations – Chronic cutaneous circumscritical scleroderma Local therapy (topical therapy) with glucocorticoids, including occlusive or intralesional at the margin. For eosinophilic fasciitis (Shulman syndrome) (affects … Scleroderma: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification. Abdominal ultrasonography (ultrasound examination of the abdominal organs). If involvement of the gastrointestinal tract (gastrointestinal tract) is suspected (clinical symptoms: dyspepsia (irritable stomach), dysphagia (dysphagia), weight loss, diarrhea (diarrhea)). If renal crisis … Scleroderma: Diagnostic Tests
All forms of scleroderma have the main symptom of cutaneous sclerosis in common. Other symptoms and complaints that follow may indicate chronic cutaneous circumscritic scleroderma: Chronic cutaneous circumscritic scleroderma: confined to the skin and adjacent tissues such as subcutaneous fat, muscle, and bone; most common form of sclerodermaThe following subtypes are distinguished: Plaque type (morphaea) … Scleroderma: Symptoms, Complaints, Signs
Pathogenesis (disease development) The exact causes of scleroderma have not yet been determined. What has been proven so far are genetic factors (HLA associations in systemic scleroderma) and pathologic (pathological) autoimmunologic processes. Thus, it is known that immunocompetent cells (T cells (belong to the most important cell groups of the cellular immune defense), macrophages (“scavenger … Scleroderma: Causes
General measures Careful and regular skin and mucous membrane care and oral and dental hygiene. Nicotine restriction (refrain from tobacco use); also avoid passive smoking – vascular toxicity! Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and participation in a medically supervised … Scleroderma: Therapy
