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Management of systemic sclerosis--a review
S C Ng1, P J Clements, H E Paulus
1Department of Medicine IV, Tan Tock Seng Hospital, Singapore.
Singapore Medical Journal
|June 1, 1990
Summary
Accurate diagnosis using American Rheumatism Association (ARA) criteria is key for managing scleroderma. Treatment involves multisystem evaluation, patient education, skin care, physiotherapy, and medications like D-penicillamine and potentially cyclosporine.
Area of Science:
- Rheumatology
- Dermatology
- Internal Medicine
Background:
- Scleroderma diagnosis and management require a systematic approach.
- Early identification of visceral involvement is crucial.
Purpose of the Study:
- To outline diagnostic and management strategies for scleroderma.
- To review current and experimental therapeutic options.
Main Methods:
- Utilizing American Rheumatism Association (ARA) diagnostic criteria.
- Performing multisystem evaluation for visceral involvement.
- Reviewing pharmacological and non-pharmacological treatment modalities.
Main Results:
- ARA criteria provide a diagnostic guideline.
- Patient education, skin care, and physiotherapy are essential supportive measures.
- Various agents show potential for Raynaud's phenomenon and early generalized scleroderma, with D-penicillamine and cyclosporine noted.
Conclusions:
- A comprehensive approach integrating diagnosis, patient education, supportive care, and targeted therapies is necessary.
- Cyclosporine shows promise, while N-acetylcysteine and chlorambucil have proven ineffective.
- Management of visceral complications is paramount.