Management of systemic sclerosis--a review.
Establishing a correct diagnosis is the first step in the management of this condition. The ARA (American Rheumatism Association) diagnostic criteria is a useful guideline. Next, a multisystem evaluation is needed to define the extent of visceral involvement. Patient education is important to enable them to understand and participate in the management of their disease. Skin care and protection from trauma and cold and physiotherapy to retard contractures are taught. Raynaud's phenomenon may be helped by topical nitrates, ketanserin, nifedipine and vasodilatory prostaglandins. D-penicillamine may be tried for patients with generalised scleroderma of less than 3 years' duration. Colchicine may help but other drugs like N-acetylcysteine and chlorambucil have tested and found ineffective. Cyclosporin seems promising. Finally, all visceral complications should be managed accordingly.
Department of Medicine IV, Tan Tock Seng Hospital, Singapore.
S C
SC
Ng
P J
PJ
Clements
H E
HE
Paulus
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006801:Humans; D010353:Patient Education as Topic; D011379:Prognosis; D011928:Raynaud Disease / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D012595:Scleroderma, Systemic / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*
D000900:Anti-Bacterial Agents