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over the fingers,The skin is smooth, shiny and tight,There is digital ischemia and ulceration with pulp infarction and atrophy,There are dilated nail fold capillaries with nail fold infarct and ragged cuticle.
There is calcinosis.
investigations:
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RF 30%
Autoantibodies:
anticentromere antibodies 75% in CREST
Antiopoisomerase 30% in diffuse
X rayfingers:
calcium deposition
Erosions
Absorption of tuft
line of management:
Educational and psychological support
Vasodilators for Raynaud’s
ACE inhibitors for renal involvement
Symptomatic
AVOID STERIODS
treatment of scleroderma should be organ based.
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hand warmers
vasodilators
sympathectomy
oesophageal symptoms:
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prokinatic agents
malabsorption:
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rotational antibiotics
renal:
require intensive control of BP
ACEi
pul hypertension:
vasodilators
oxygen
warfarin
pul fibrosis:
cyclophosphamide
azathioprin
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