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 program for patients with underweight / malnutrition.
- In the presence of Raynaud’s symptomatology (vascular disease caused by vasospasm (vascular spasm)), cold should be avoided.
Conventional non-surgical therapy methods
- In cases of (impending) malnutrition: enteral nutrition (nutrition via the gastrointestinal tract; PEG tube (percutaneous endoscopic gastrostomy; an endoscopically created artificial access from the outside to the stomach) or PEJ tube (jejunal tube; tube into the small intestine)) or parenteral nutrition (form of artificial nutrition that bypasses the gastrointestinal tract).
Vaccinations
The following vaccinations are advised, as infection can often lead to worsening of the present disease:
- Flu vaccination
- Pneumococcal vaccination
Regular checkups
- Regular medical checkups
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Approximately 30% of scleroderma patients are at increased risk for malnutrition:
- Energy requirements are increased due to systemic inflammatory processes.
- If the gastrointestinal tract (GI tract) is affected, nutrient absorption is impaired.
- In the case of microstomies (the mouth can no longer be opened wide), food absorption is also difficult.
- Observe the following special dietary recommendations:
- Three main meals and two snacks between meals.
- Intermediate meals high-calorie and high-protein (eg, a fully balanced diet for the dietary management of patients with catabolic metabolism).
- Adaptation of nutritional medical measures to the present organ-specific symptoms of each scleroderma patient.
- Selection of appropriate foods based on the nutritional analysis.
- See also under “Therapy with micronutrients (vital substances)” – Taking a suitable food supplement (eg, fully balanced diet for the dietary treatment of persons with catabolic metabolic state – energy concentrate as a drinkable food as a snack).
- Detailed information on nutritional medicine can be obtained from us.
Physical therapy (including physiotherapy)
The various methods are intended to decongest, soften and mobilize the skin. Breathing should be improved and pneumonia (pneumonia) prevented. Likewise, joint mobility should be maintained or improved to prevent contractures (stiffness), among other things.
- Occupational therapy (“work or occupational therapy”).
- Massages
- Physiotherapy – for systemic scleroderma.
- UV therapy
- UV-A, UV-B, bathing PUVA – for systemic sclerosis (SSc).
- UV-B, UV-A – in morphea (inflammatory disease in which individual areas of the skin harden).
- (UV-B) – in eosinophilic fasciitis/disease of connective tissue, in which there is inflammation of the fascia with swelling and hardening of the skin and an increased incidence of eosinophilic granulocytes in the blood (eosinophilia); is assigned to the group of localized scleroderma
- UV-A1, UV-B, bathing PUVA – in Sceloderma adultorum.
PUVA therapy (combined use of psoralen and UVA light), topical (“local”) or bath PUVA – in case of involvement of connective tissue (e.g..B. Fibrosclerosis):
