Written by: Deen Kurrimbux

Scleroderma is a skin disease that results in hard, thickening of the outer dermal layer. It is an uncommon autoimmune disease with no known cure that affects the lower layers and the surrounding organs and blood vessels. The areas appear either as thick oval patches anywhere on the body or as lines on the face, scalp, arms and legs.

Treatment is dependent on severity of symptoms. In mild cases treatment is no needed. There are two types of scleroderma: localised and systemic sclerosis. Localised scleroderma which is the mildest form of the condition, affects just the skin and can occur at any age. There are two types of localised scleroderma, morphoea (pr. mor-phee-a) are oval patches that can be itchy, hairless and have a lighter or darker appearance to the surrounding skin and may fade away after a few years. Linear scleroderma as the name suggests, appears as lines across the face and body and particularly as it can affect persons of any age, children are at risk as it can affect growing bones and tissue which if left untreated will cause deformities.

Systemic sclerosis affects the internal organs as well as the skin. Internal complications can be heartburn and trouble swallowing. External complications include, skin swelling and tightening, stiffness in the joints, hair loss, weight loss and fatigue. Systemic sclerosis occurs more in adult females between the ages of 30-50 and can be categorised in two forms: the first (limited cutaneous systemic sclerosis) is a milder, slower, progressive form of sclerosis with thickening of the skin on the face and limbs; the second is diffuse systemic sclerosis where the symptom-onset is sudden and worse over the first few years then settles and the skin may show improvement. In some cases systemic sclerosis affects the heart, lungs, kidneys and intestines, causing hypertension, shortness of breath, renal damage and constipation and diarrhoea respectively.

Scleroderma is an autoimmune disease which means the immune system will attack foreign and non-foreign bodies alike. In the case of scleroderma the body produces too much collagen which causes fibrosis – thickening and scarring – of the tissue.

There is no known cure for scleroderma, so treatment is limited to relieving the symptoms, preventing the disease from worsening and minimise the disability with physiotherapy. Medications that improve blood flow, suppress the immune system and help repair damaged skin are administered. Topical moisturisers may help reduce skin tightness and improve mobility as is regular exercise keeping the joints limber. In extreme cases surgery would be needed to “release” bound tissue which restricts movement internally.

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